Individual
DR. DANIEL KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
680 N LAKE SHORE DR STE 924, CHICAGO, IL 60611-8701
(847) 866-7846
Mailing address
680 N LAKE SHORE DR STE 924, CHICAGO, IL 60611-8701
(847) 866-7846
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ML60770434
WA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036152896
IL
390200000X
Student in an Organized Health Care Education/Training Program
ML60770434
WA
Other
Enumeration date
06/19/2017
Last updated
06/28/2021
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