Individual
DR. THOMAS CHARLES KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
207 LANDMARK DR, SUITE A, NORMAL, IL 61761-3195
(309) 268-3200
Mailing address
701 LEE ST, SUITE 300, DES PLAINES, IL 60016-4539
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301084281
MI
Other
Enumeration date
05/31/2007
Last updated
11/20/2012
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