Individual
KELLY R FLOWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4121 W GLADYS AVE, CHICAGO, IL 60624-2730
(773) 842-9969
Mailing address
4121 W GLADYS AVE, CHICAGO, IL 60624-2730
(773) 842-9969
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
22
IL
Other
Enumeration date
09/03/2010
Last updated
09/03/2010
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