Individual
DR. KELLEY ORALIVIA HOLLOWAY - MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2003 W FULTON ST STE 303, CHICAGO, IL 60612-2345
(312) 243-2223
(312) 243-2227
Mailing address
2003 W FULTON ST STE 303, CHICAGO, IL 60612-2345
(312) 243-2223
(312) 243-2227
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
016005544
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07001151A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100048065
—
WI
05
—
201168580
—
IN
01
—
P01703698
RAILROAD MEDICARE
WI
01
—
P01725310
RAILROAD MEDICARE
IN
Enumeration date
05/19/2011
Last updated
07/06/2022
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