Graham, Kelly

Graham, Kelly is an individual health care provider with primary practice located at 9601 165Th St Suite 6, Orland Park IL 60467-5660. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Graham, Kelly can be contacted via phone (708) 539-8002.

Contact Information

Primary practice address
9601 165Th St Suite 6 Orland Park IL 60467-5660
Phone: (708) 539-8002
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 71006989 Illinois

Profile Details

NPI number 1144397001
LBN Legal business name Graham, Kelly
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144397001 NPPES
Illinois MEDICAID 71006989

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