| NPI Details | |
|---|---|
| NPI | 1568695799 |
| Gender | Female |
| Enumeration Date | 09/04/2009 |
| Last Updated | 09/13/2013 |
| Entity Type | Individual |
| Active | Over 8 years ago |
| Practice Location | |
|---|---|
| 2200 WABASH AVE SPRINGFIELD IL, 62704-5352, US |
|
| Phone | (217) 528-7541 |
| Fax | (217) 528-8962 |
| Business Location | |
|---|---|
| 1025 S 6TH ST SPRINGFIELD IL, 62703-2403, US |
|
| Phone | (217) 528-7541 |
| Fax | (217) 528-8962 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 363A00000X |
| License State | Illinois |
| License Number | 085003555 |
| Remove 1568695799 NPI Number | |
According to our database, Colleen E Kelly PA NPI is 1568695799, taxonomy code is 363A00000X and license number is 085003555, license state is located at Illinois. Colleen E Kelly PA physically located at 2200 Wabash Ave, Springfield IL, 62704-5352. NPI Number Colleen E Kelly PA has the Individual type.
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1568695799 NPI number is provided on an as is basis without warranty of any kind. 1568695799 is maintained by the National Plan & Provider Enumeration System. The contents of Colleen E Kelly PA are for informational purposes only.
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