Individual
KELLY ROEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 942-0513
Mailing address
525 S DEARBORN ST, APT 309, CHICAGO, IL 60605-1524
(312) 942-0513
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.005110
IL
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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