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NPI 1013806256

NPI 1013806256 : ERIN L KELLY LMSW : DARIEN, IL

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General NPI Number Information
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    NPI Number           |    1013806256
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    Entity Type          |    Individual 
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    Provider Name        |    ERIN L KELLY LMSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/01/2025
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    Last Update Date     |    07/01/2025
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Provider Practice Location Address
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    Address Line         |    7900 CASS AVE STE 200 
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    City                 |    DARIEN
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    State                |    IL
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    Zip                  |    60561-5073
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    Country              |    US
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    Telephone            |    630-884-8643
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3338 W 107TH ST 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60655-2512
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    Country              |    US
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    Telephone            |    739-992-7057
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    150115819
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    License Number State |    IL
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