Individual
MS. KELLY DAWN CHULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
120 E HERRIN ST, HERRIN, IL 62948-3163
(618) 988-9830
(618) 988-9830
Mailing address
120 E HERRIN ST, HERRIN, IL 62948-3163
(618) 988-9830
(618) 988-9830
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038010250
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038010250
—
IL
01
—
2832012
BCBS
IL
Enumeration date
11/06/2006
Last updated
10/29/2013
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