Most Relevant Information
Provider Data
| NPI Number: | 1003494501 |
| Provider Name: | KELSEY ROSE KENNEDY MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/29/2021 |
| Last Updated: | 06/26/2024 |
Provider Practice Location
4440 W 95TH ST
OAK LAWN
IL
604532600
Practice Location Phone/Fax
| Phone: | 7086845375 |
| Fax: |
Provider Mailing Location
4440 W 95TH ST
OAK LAWN
IL
604532600
Provider Mailing Phone/Fax
| Phone: | 7086845375 |
| Fax: | 7086843776 |