Individual
KELLY RANKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2202 ESSINGTON RD, SUITE 101, JOLIET, IL 60435-1634
(815) 676-5310
(815) 725-1321
Mailing address
2202 ESSINGTON RD, SUITE 101, JOLIET, IL 60435-1634
(815) 676-5310
(815) 725-1321
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004503
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085004503
STATE LICENSE
IL
Enumeration date
02/05/2013
Last updated
07/29/2013
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