Individual
DR. KELLY DINEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 E DELAWARE PL STE 310, CHICAGO, IL 60611-4962
(773) 720-1623
Mailing address
5250 GRAND AVE # 14-390, GURNEE, IL 60031-1877
(847) 212-1015
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
071006880
IL
Other
Enumeration date
07/15/2005
Last updated
04/22/2020
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