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Individual
MR. KEITH MICHAEL LADENDORF
Active
Individual
MR. KEITH MICHAEL LADENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
085-002545
IL
363AS0400X
Surgical Physician Assistant
Primary
085002545
IL
Other
Enumeration date
03/21/2007
Last updated
01/23/2023
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