Kelly, Mallory

Kelly, Mallory is an individual health care provider with primary practice located at 1113 Dixon St , Washington IL 61571-9004. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Kelly, Mallory can be contacted via phone (217) 502-2672.

Contact Information

Primary practice address
1113 Dixon St Washington IL 61571-9004
Phone: (217) 502-2672
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 125.064460 Illinois
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 125.064460 Illinois

Profile Details

NPI number 1174938690
LBN Legal business name Kelly, Mallory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2014
Last updated Jun 23rd, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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