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1780296053
KELLY WALLNER
PARK RIDGE, IL
NPI
1780296053
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: IL 146.016037)
Enumeration Date
2020-08-18
Last Update Date
2023-03-26
Business Address
KELLY WALLNER
1001 S FAIRVIEW AVE
PARK RIDGE, IL 60068-4712
Phone number: 847-318-4235
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Mailing Address
KELLY WALLNER
3424 HOLLYWOOD AVE
BROOKFIELD, IL 60513-1702
Phone number: 708-250-9181
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