Individual
KEELY E PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 N WESTMORELAND RD, LAKE FOREST, IL 60045-1658
(847) 535-6150
(847) 535-7801
Mailing address
1000 N WESTMORELAND RD, LAKE FOREST, IL 60045-1658
(847) 535-6150
(847) 535-7801
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004520
IL
Other
Enumeration date
10/01/2012
Last updated
11/11/2024
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