Individual
MRS. KELLY LYNN STILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1410 E MAIN ST, STREATOR, IL 61364-3147
(815) 830-6918
Mailing address
4108 MAIN ST, STREATOR, IL 61364-9667
(815) 830-6918
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
227.008317
IL
Other
Enumeration date
06/20/2008
Last updated
06/20/2008
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