Provider Demographics
NPI:1508454901
Name:KELLY, MARGARET (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:KELLY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 ATHENS RD
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1955
Mailing Address - Country:US
Mailing Address - Phone:708-743-9090
Mailing Address - Fax:708-283-1806
Practice Address - Street 1:2517 ATHENS RD
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1955
Practice Address - Country:US
Practice Address - Phone:708-743-9090
Practice Address - Fax:708-283-1806
Is Sole Proprietor?:No
Enumeration Date:2021-01-02
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical