Keller, Kelli Marie

Keller, Kelli Marie is an individual health care provider with primary practice located at 24600 W 127Th St Ste B325, Plainfield IL 60585-9502. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Keller, Kelli Marie can be contacted via phone (815) 731-9100.

Contact Information

Primary practice address
24600 W 127Th St Ste B325 Plainfield IL 60585-9502
Phone: (815) 731-9100
Fax: (815) 731-9110
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 36117064 Illinois

Profile Details

NPI number 1730207820
LBN Legal business name Keller, Kelli Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2007
Last updated Mar 10th, 2009 - about 17 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 1730207820 NPPES
Illinois Other 2220936 BCBS
Illinois MEDICAID 036117064 2 BCBS

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