Individual
KEITH MICHAEL WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, CRC
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-5517
Mailing address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-5517
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
—
—
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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