Search › Illinois › 363A00000X
Kelly Dietrick
NPI 1265393003 · on the registry since 2025
Practice
- Address
- 6140 N Broadway St
Chicago, IL 60660 - Phone
- (224) 795-3521
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-11-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois