| Doctor Name: | KELLY J BRAWLEY |
| NPI Number: | 1154396745 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.A. |
| License Number: | 085-001816 |
| Business Practice Address: | 910 Highway 22 Fox River Grove, IL - 600211905 |
| Business Phone Number: | 8474621700 |
| Business Fax Number: | 8474621792 |
| Mailing Address: | 910 Highway 22, FOX RIVER GROVE |
| State: | IL |
| Postal Code: | 600211905 |
| Phone Number: | 8474621700 |
| Fax Number: | 8474621792 |
| NPI Enumeration Date: | 02/17/2006 |
| NPI Last Update Date: | 05/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 085-001816 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |