Organization
KEITH M. MONSON, M.D., SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH M. MONSON M.D. (PRESIDENT)
(815) 932-6400
Entity
Organization
Contact information
Practice address
400 N WALL ST, SUITE 304, KANKAKEE, IL 60901-2940
(815) 932-6400
(815) 935-7062
Mailing address
P.O. BOX 1756, KANKAKEE, IL 60901-1756
(815) 932-6400
(815) 935-7062
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4632066
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/20/2006
Last updated
08/22/2020
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