Provider Demographics
NPI:1598142788
Name:WELINDT, KELLY F (MD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:F
Last Name:WELINDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:S
Other - Middle Name:KELLY
Other - Last Name:FORSYTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:417 LATHROP AVENUE
Mailing Address - Street 2:UNIT 4E
Mailing Address - City:RIVERS FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1874
Mailing Address - Country:US
Mailing Address - Phone:708-703-2050
Mailing Address - Fax:708-848-1330
Practice Address - Street 1:417 LATHROP AVENUE
Practice Address - Street 2:UNIT 4E
Practice Address - City:RIVERS FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1874
Practice Address - Country:US
Practice Address - Phone:708-703-2050
Practice Address - Fax:708-848-1330
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.082839207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine