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Individual

DR. KELLY RENEE RYCHTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1205 S MAIN ST STE 101, CROWN POINT, IN 46307-3677
(219) 662-0077
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.118144
IL
207RC0000X
Cardiovascular Disease Physician
Primary
02005931A
IN
207RC0000X
Cardiovascular Disease Physician
036.118144
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036118144
IL
01
1124399605
GROUP NPI
IL
Enumeration date
01/24/2008
Last updated
03/20/2021
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