Individual
ELIZABETH M KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
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
164W00000X
Licensed Practical Nurse
209009226
IL
363LF0000X
Family Nurse Practitioner
Primary
209009226
IL
Other
Enumeration date
01/10/2012
Last updated
11/29/2022
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