Individual
ADAM CHRISTOPHER KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
36500 AURORA DR, DEPARTMENT OF PEDIATRICS- NEONATAL ICU, SUMMIT, WI 53066-4899
(262) 434-4900
(262) 434-4901
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2363-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100011852
—
WI
01
—
2363-23
WISCONSIN LICENSE
WI
Enumeration date
11/01/2007
Last updated
10/14/2024
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