Individual
DR. KEITH CHARLES RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
138 S OAK AVE, BARTLETT, IL 60103-6620
(630) 830-1500
(630) 830-2513
Mailing address
138 S OAK AVE, BARTLETT, IL 60103-6620
(630) 830-1500
(630) 830-2513
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038010561
IL
111N00000X
Chiropractor
CH7396
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3817636
—
FL
01
—
55689
BCBS
—
01
—
AD239
MEDICARE GROUP ID
FL
Enumeration date
12/07/2006
Last updated
07/26/2012
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