Provider Demographics
NPI:1356690325
Name:O'MALLEY, KELLY (AUD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:O'MALLEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 W HIGGINS RD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-7251
Mailing Address - Country:US
Mailing Address - Phone:847-490-1670
Mailing Address - Fax:847-490-1703
Practice Address - Street 1:3100 W HIGGINS RD
Practice Address - Street 2:SUITE 145
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-7251
Practice Address - Country:US
Practice Address - Phone:847-490-1670
Practice Address - Fax:847-490-1703
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter