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1265888655
MICHAEL C KELLY
CHICAGO, IL
NPI
1265888655
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: IL 19030568)
Enumeration Date
2016-05-04
Last Update Date
2019-12-24
Business Address
MICHAEL C KELLY D.M.D
5425 W LAKE ST
CHICAGO, IL 60644-2342
Phone number: 773-378-3347
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Mailing Address
MICHAEL C KELLY D.M.D
568 S SPRING RD STE A
ELMHURST, IL 60126-3868
Phone number:
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