Organization
CHICAGO FAMILY ASTHMA & ALLERGY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY K NEWHALL MD (PRESIDENT)
(773) 388-2322
Entity
Organization
Contact information
Practice address
2551 N CLARK ST, SUITE 100, CHICAGO, IL 60614-1798
(773) 388-2322
(773) 388-2333
Mailing address
2551 N CLARK ST, SUITE 100, CHICAGO, IL 60614-1798
(773) 388-2322
(773) 388-2333
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
036105585
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001628998
BCBS PROV #
IL
Enumeration date
12/29/2008
Last updated
08/31/2015
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