Park, Kelly

Park, Kelly is an individual health care provider with primary practice located at 1200 Shermer Rd Ste 200 , Northbrook IL 60062-4563. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is her primary health care specialty. Park, Kelly can be contacted via phone (847) 559-0090.

Contact Information

Primary practice address
1200 Shermer Rd Ste 200 Northbrook IL 60062-4563
Phone: (847) 559-0090
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 036.143099 Illinois
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 036143099 Illinois

Profile Details

NPI number 1659683993
LBN Legal business name Park, Kelly
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2010
Last updated Feb 20th, 2024 - about 2 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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