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Contact Information

MICHAEL J KELLIS, DO
150 SEVENTH AVE STE 200
CHARDON, OH44024-2909
 Phone: 440-285-4999
 Fax: 402-855-8704
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

207RS0010X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for MICHAEL J KELLIS · (Male)

NPI Number 1831190313
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 08/09/2005
Last updated 11/02/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 34004183
  • OH Medicaid 0658051
  • OH Other 4073792 AETNA
  • OH Other 139662 ANTHEM
  • OH Other 250006704 RR MEDICARE
Hospital affiliation(s)
  • LAKE HEALTH - (Acute Care)
    7590 AUBURN ROAD
    CONCORD, OH 44077
  • UH GEAUGA MEDICAL CENTER - (Acute Care)
    13207 RAVENNA RD
    CHARDON, OH 44024
  • UHHS RICHMOND HEIGHTS HOSPITAL - (Acute Care)
    27100 CHARDON ROAD
    RICHMOND HEIGHTS, OH 44143
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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