Individual
BREANNA ELIZABETH-HOWE KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006681
IL
363A00000X
Physician Assistant
363A00000X
MI
Other
Enumeration date
09/22/2015
Last updated
05/21/2022
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