Dr Mary Kelly

LBN: Dr Mary Kelly
Dr Mary Kelly is an health care organization with primary practice located at 7319 North Ave , River Forest IL 60305-1220. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Dr Mary Kelly can be contacted via phone (708) 848-0040, or through Kelly, Mary via phone (708) 848-0040.

Contact Information

Primary practice address
7319 North Ave River Forest IL 60305-1220
Phone: (708) 848-0040
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kelly, Mary
Phone: (708) 848-0040

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036077560 Illinois

Profile Details

NPI number 1164683157
LBN Legal business name Dr Mary Kelly
DBA Doing business as
Authorized official Kelly, Mary
Entity Organization
Organization subpart 1 No
Enumeration date Jun 23rd, 2008
Last updated Jun 23rd, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164683157 NPPES
Illinois MEDICAID 036077560

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