Most Relevant Information
Provider Data
| NPI Number: | 1003001405 |
| Provider Name: | KELLY L DEVINE MS, RDN, LDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 164.004722 |
Most Important Dates
| Enumeration Date: | 09/09/2007 |
| Last Updated: | 03/04/2024 |
Provider Practice Location
6811 167TH ST STE 6
TINLEY PARK
IL
604772501
Practice Location Phone/Fax
| Phone: | 7086089014 |
| Fax: | 7083770060 |
Provider Mailing Location
6521 CHARLESTON ST
OAK FOREST
IL
604522626
Provider Mailing Phone/Fax
| Phone: | 7086120876 |
| Fax: |