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General NPI Number Information
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NPI Number | 1639060197
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Entity Type | Individual
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Provider Name | KELLY MCENTEE APRN
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Gender | Female
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 110 S RIVER RD STE 7
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City | DES PLAINES
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State | IL
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Zip | 60016-3440
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Country | US
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Telephone | 847-294-9614
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Fax | 847-294-9644
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Provider Business Mailing Address
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Address Line | 110 S RIVER RD STE 7
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City | DES PLAINES
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State | IL
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Zip | 60016-3440
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Country | US
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Telephone | 847-294-9614
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Fax | 847-294-9644
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 041.587136
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 364SW0102X
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Taxonomy Name | Women's Health Clinical Nurse Specialist
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License Number | APRN.CNP.0039570
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License Number State | OH
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