MARY L. KELLY, D.O., S.C. (NPI# 1497903314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497903314 |
| Entity Type | Organization |
| Organization Name | MARY L. KELLY, D.O., S.C. |
| Practice Address |
7319 North Ave River Forest IL 60305-1220 |
| Practice Telephone | 7088480040 |
| Practice Fax Number | 7088482931 |
| Mailing Telephone | 7088480040 |
| Mailing Fax Number | 7088482931 |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2008-09-04 |
| Authorized Official Name | MARY L. L KELLY (PRESIDENT) |
| Authorized Official Telephone | 7088480080 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
036077560 | IL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649573882 | Mary L. Kelly, D.o., S.c. | Clinic/Center | 1125 Westgate St, Oak Park, IL 60301-1007 | 2010-12-09 |
| Street Address |
7319 NORTH AVE |
| City | RIVER FOREST |
| State | IL |
| Zip Code | 60305-1220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003923764 | Tae-jun Ahn | Podiatrist | 7319 North Ave, River Forest, IL 60305-1220 | 2006-08-25 |
| 1164683157 | Dr Mary Kelly | Family Medicine | 7319 North Ave, River Forest, IL 60305-1220 | 2008-06-23 |
| 1871690008 | Merit Center for Sleep Health of Oak Park, LLC | Clinic/Center | 7319 North Ave, River Forest, IL 60305 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063969004 | Logan N Nierzwicki | Physical Therapist | 7341 A Lake St, River Forest, IL 60305 | 2016-09-07 |
| 1427442292 | Gina Patel | Physical Therapist | 7341a Lake St, River Forest, IL 60305 | 2015-03-19 |
| 1316369630 | Kristin Burns | Social Worker | 1115 Thatcher Ave, River Forest, IL 60305 | 2014-01-07 |
| 1508102823 | Elizabeth Ralyea | Nurse Practitioner | 7251 W Lake Street, River Forest, IL 60305 | 2012-12-13 |
| 1194009175 | Mani Chhibba | Optometrist | 7345 West Lake Street, River Forest, IL 60305 | 2011-10-07 |
| 1508069212 | Fatima Ali Hyder | Internal Medicine | 7343 Lake St, River Forest, IL 60305 | 2007-06-08 |
| 1932314069 | Karen Vanslyck Darley | Dentist | 340 Lathryn Ave, River Forest, IL 60305 | 2007-05-11 |
| 1083836571 | Lucelita Abad Duffy | Physical Therapist | 7411 Lake Street, Rehabilitation & Sports Medicine West Suburban Resurrec, River Forest, IL 60305 | 2007-05-03 |
| 1457484669 | Michelle Annette Melyn | Psychiatry & Neurology | 7777 West Lake St, River Forest, IL 60305 | 2007-03-14 |
| 1588797757 | Marie T Walsh | Dentist | 7765 W. North Ave., River Forest, IL 60305 | 2007-03-14 |
| Find all providers in zip 60305 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295351062 | Sara M Gotheridge Md LLC | Clinic/Center | 630 Davis St Ste 301, Evanston, IL 60201-4480 | 2020-06-17 |
| 1407484645 | Macumber Medical Ltd | Clinic/Center | 3114 W Irving Park Rd Ste 1w, Chicago, IL 60618-3435 | 2020-04-01 |
| 1477181782 | Embassy Studios North | Clinic/Center | 6455 N Cicero Ave, Lincolnwood, IL 60712-3407 | 2020-03-31 |
| 1689226318 | Midway Spine and Joint Pain Physicians | Clinic/Center | 5720 S Pulaski Rd, Chicago, IL 60629-4435 | 2019-07-12 |
| 1215598891 | Vero Clinics | Clinic/Center | 1192 E Pershing Rd, Decatur, IL 62526-4753 | 2019-06-25 |
| 1497215933 | Activate Healthcare | Clinic/Center | 2010 N Damen Ave Unit F, Chicago, IL 60647-3286 | 2019-03-21 |
| 1033699467 | Healthpointe Medical Center Sc | Clinic/Center | 530 Fullerton Rd Ste B, Swansea, IL 62226-2970 | 2018-08-15 |
| 1740794882 | Highland Park Cvs, L.L.C. | Clinic/Center | 72 Airport Plz, Bethalto, IL 62010-1774 | 2017-11-28 |
| 1447764014 | Dr Courtney Drendel Inc | Clinic/Center | 515 Hamilton St # 100, Geneva, IL 60134-2138 | 2017-11-19 |
| 1699206599 | David M Conner M.d. | Clinic/Center | 9 Executive Woods Ct Ste 2, Swansea, IL 62226-2016 | 2017-03-22 |
| Find all providers with the same taxonomy | ||||
| City | RIVER FOREST |
| Zip Code | 60305 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.