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1235601113
KELLY CODERRE
CHICAGO, IL
NPI
1235601113
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085.006717)
Enumeration Date
2018-12-17
Last Update Date
2018-12-17
Business Address
KELLY CODERRE
1500 S FAIRFIELD AVE
CHICAGO, IL 60608-1782
Phone number: 773-542-2000
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Mailing Address
KELLY CODERRE
820 BRUCE AVE
FLOSSMOOR, IL 60422-1250
Phone number: 708-612-6036
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