Individual
MRS. KELLI FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
638 W KEMPER PL, CHICAGO, IL 60614-3312
(312) 420-1639
Mailing address
638 W KEMPER PL, CHICAGO, IL 60614-3312
(312) 480-5297
(708) 795-4834
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.014681
IL
Other
Enumeration date
08/13/2012
Last updated
03/06/2014
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