Wallace T Kellum is a Driver based in Chicago, IL. Wallace T Kellum practices in Chicago, IL. The NPI Number for Wallace T Kellum is 1255043089 and holds a License No. CG83801 (Illinois).
The current practice location address for Wallace T Kellum is 5949 S Aberdeen St, Chicago, IL and can be reached out via phone at 773-556-9732.
Location: 5949 S Aberdeen St, Chicago, IL, 60621-1429
Provider Profile Details
NPI Number
1255043089
Provider Name
Wallace T Kellum
Credential
Provider Entity Type
Individual
Gender
Male
Address
5949 S Aberdeen St, Chicago, IL, 60621-1429
Phone Number
773-556-9732
Fax Number
Provider Enumeration Date
12/26/2022
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
5949 S Aberdeen St
City
State
Zip
60621-1429
Phone Number
773-556-9732
Fax Number
Provider Business Mailing Address Details
Address
5949 S Aberdeen St
City
State
Zip
60621-1429
Phone Number
773-556-9732
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Driver
Speciality
-
Taxonomy
License No.
CG83801 (Illinois)
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
Badge
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