Individual
DR. SHIRLEY ALLEN MAIDES-KEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2625 BUTTERFIELD RD, SUITE 138 SOUTH, OAK BROOK, IL 60523-1234
(630) 990-1919
(630) 990-3151
Mailing address
2625 BUTTERFIELD RD, SUITE 138 SOUTH, OAK BROOK, IL 60523-1234
(630) 990-1919
(630) 990-3151
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002272088
BLUE SHIELD PROVIDER #
IL
Enumeration date
03/13/2007
Last updated
07/08/2007
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