Kelly, Tania
Kelly, Tania is an individual health care provider with primary practice located at 4440 W 95Th St , Oak Lawn IL 60453-2600. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Kelly, Tania can be contacted via phone (708) 684-5341.Contact Information
Primary practice address
4440 W 95Th St
Oak Lawn IL 60453-2600
Phone: (708) 684-5341
Fax: (708) 684-4767
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036112183 | Illinois |
Profile Details
| NPI number | 1457443384 |
|---|---|
| LBN Legal business name | Kelly, Tania |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 28th, 2006 |
| Last updated | Mar 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457443384 | NPPES |
| Illinois | MEDICAID | 036112183 |
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