Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 036140391 | IL |
NPI | 1427505197 |
---|---|
Provider Name | Kelly Hynes |
First Address | Chicago, IL 60637-1447 |
Second Address | Chicago, IL 60637-1447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2016 |
Last Update Date | 01/11/2016 |