| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CLARE KELLY REIDY | 1952098568 | 2023-07-26 |
Clare Kelly Reidy is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1952098568. Registration indicates Clare Kelly Reidy is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) (Emergency Medicine, ) (Allopathic & Osteopathic Physicians, Emergency Medicine) (All Other Specialties & Provider Types, ) (Emergency Medicine, Allopathic & Osteopathic Physicians)
| Entity Type | Individual |
| Provider Name | Dr. Clare Kelly Reidy DO |
| Practice Office Address | 7435 W TALCOTT AVE CHICAGO, IL US |
| Practice Office Telephone | 7737925155 |
| Practice Office Fax | 7735947975 |
| Mailing Address | 7435 W TALCOTT AVE CHICAGO, IL 606313746 US |
| Business Telephone | 7737905255 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 207P00000X PRIMARY | Emergency Medicine Allopathic & Osteopathic Physicians Emergency Medicine All Other Specialties & Provider Types Emergency Medicine Allopathic & Osteopathic Physicians | 125.081298
IL |