Provider Demographics
NPI:1376988238
Name:KALISKI, CELESTE D (MD)
Entity Type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:D
Last Name:KALISKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-4893
Mailing Address - Country:US
Mailing Address - Phone:815-741-1305
Mailing Address - Fax:
Practice Address - Street 1:705 WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60431-4893
Practice Address - Country:US
Practice Address - Phone:815-741-1305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.074832207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine