Search › Illinois › 103TB0200X
Paul Kelly
NPI 1629773478 · on the registry since 2023
Practice
- Address
- 7921 S Trumbull Ave
Chicago, IL 60652 - Phone
- (708) 728-5460
Registry record
- Primary taxonomy
- 103TB0200X
103TB0200X
- Also registered as
- 101YP2500X
103TB0200X - Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-11-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois