Provider Demographics
NPI:1003191032
Name:CALL KELLEY
Entity Type:Organization
Organization Name:CALL KELLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-863-5235
Mailing Address - Street 1:102 WILLIAMSBURG LN
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2915
Mailing Address - Country:US
Mailing Address - Phone:630-749-0519
Mailing Address - Fax:
Practice Address - Street 1:102 WILLIAMSBURG LN
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-2915
Practice Address - Country:US
Practice Address - Phone:630-749-0519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care