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General NPI Number Information
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NPI Number | 1598142788
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Entity Type | Individual
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Provider Name | KELLY F WELINDT M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 04/27/2015
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Provider Practice Location Address
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Address Line | 417 LATHROP AVENUE UNIT 4E
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City | RIVERS FOREST
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State | IL
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Zip | 60305-1874
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Country | US
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Telephone | 708-703-2050
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Fax | 708-848-1330
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Provider Business Mailing Address
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Address Line | 417 LATHROP AVENUE UNIT 4E
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City | RIVERS FOREST
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State | IL
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Zip | 60305-1874
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Country | US
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Telephone | 708-703-2050
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Fax | 708-848-1330
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036.082839
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License Number State | IL
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