LANCE KELLY

MAYWOOD, IL
NPI1831694892
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207L00000X Anesthesiology
(Licence: IL  036154058)
Additional Taxonomies207L00000X Anesthesiology
(Licence: IL  125.072310)
Enumeration Date2018-03-29
Last Update Date2022-06-26
Business Address
DR. LANCE KELLY MD
2160 S 1ST AVE
MAYWOOD, IL 60153
Phone number: 708-216-9169
Mailing Address
DR. LANCE KELLY MD
2160 S 1ST AVE
MAYWOOD, IL 60153-3328
Phone number: 505-220-5446