Julie L Kelley, MD | |
325 Spring St, Red Bud, IL 62278-1105 | |
(618) 282-3831 | |
(618) 282-1919 |
Full Name | Julie L Kelley |
---|---|
Gender | Female |
Speciality | Family Medicine |
Location | 325 Spring St, Red Bud, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306980552 | NPI | - | NPPES |
36100230 | Other | IL | STATE LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 36100230 (Illinois) | Primary |
Entity Name | Red Bud Illinois Hospital Company Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740387042 PECOS PAC ID: 2466416821 Enrollment ID: O20041116000148 |
Entity Name | Red Bud Physician Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053619148 PECOS PAC ID: 0648454520 Enrollment ID: O20110419000082 |
Entity Name | Deaconess Illinois Clinic Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1962128256 PECOS PAC ID: 5092187021 Enrollment ID: O20230220002667 |
Entity Name | Deaconess Illinois Red Bud Regional Hospital Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619693926 PECOS PAC ID: 9537531579 Enrollment ID: O20230221000484 |
Entity Name | Deaconess Illinois Specialty Clinic, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972210235 PECOS PAC ID: 9830562016 Enrollment ID: O20230321001688 |
Mailing Address | Practice Location Address |
---|---|
Julie L Kelley, MD 325 Spring St, Red Bud, IL 62278-1105 Ph: (618) 282-3831 | Julie L Kelley, MD 325 Spring St, Red Bud, IL 62278-1105 Ph: (618) 282-3831 |