Kelly, Erin M.

Kelly, Erin M. is an sole proprietor health care provider with primary practice located at 3001 Green Bay Road , North Chicago IL 60064. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Kelly, Erin M. can be contacted via phone (847) 636-3786.

Contact Information

Primary practice address
3001 Green Bay Road North Chicago IL 60064
Phone: (847) 636-3786
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X

Profile Details

NPI number 1508030073
LBN Legal business name Kelly, Erin M.
Credentials R.D., L.D.N.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 16th, 2008
Last updated Jun 16th, 2011 - about 15 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 1508030073 NPPES
Illinois Other L91589 MEDICARE PART B

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