Individual
MS. VICKI STEWART KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6046 W 63RD ST, CHICAGO, IL 60638-4342
(773) 586-8360
Mailing address
6046 W 63RD ST, CHICAGO, IL 60638-4342
(773) 586-8360
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
03/06/2009
Last updated
03/06/2009
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