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NPI Code Detail

MEDICARE: DR. MICHAEL A KELLY MD

MEDICARE: DR. MICHAEL A KELLY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician036068618IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2CS336032647OTHERILIL DEPT OF FE PROF REG

General Provider Information

NPI Number : 1558329086
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL A KELLY MD
Provider Business Mailing Address
First Line : 1725 W HARRISON
Second Line : RU ME #1106 UNIVERSITY NEUROLOGISTS
City : CHICAGO
State : IL
Zip : 60612-3824
Country : US
Telephone Number : 312-942-4500
Fax Number : 312-942-2380
Provider Business Practice Location Address
First Line : 1901 W HARRISON ST
Second Line : JOHN H. STROGER, JR. HOSPITAL OF COOK COUNTY
City : CHICAGO
State : IL
Zip : 60612-3714
Country : US
Telephone Number : 312-864-7280
Fax Number : 312-864-9787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 03/07/2023

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Directions to “ DR. MICHAEL A KELLY MD” Practice Location

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