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1255965208
KELLY A PETERSON
CHICAGO, IL
NPI
1255965208
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LN0005X Nurse Practitioner, Neonatal, Critical Care
(Licence: IL 209.020968)
Enumeration Date
2020-02-28
Last Update Date
2020-02-28
Business Address
KELLY A PETERSON
225 E CHICAGO AVE
CHICAGO, IL 60611-2991
Phone number: 312-227-4000
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Mailing Address
KELLY A PETERSON
12516 S 71ST CT
PALOS HEIGHTS, IL 60463-1550
Phone number: 708-768-1694
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