Individual
DR. KEITH MEDERNACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2100 W STATE ST, GENEVA, IL 60134-3693
(630) 262-0970
Mailing address
2100 W STATE ST, GENEVA, IL 60134-3693
(630) 262-0970
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051041084
IL
Other
Enumeration date
09/07/2011
Last updated
09/07/2011
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