Individual
DR. KEITH DAVID BOWERSOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D, PHD
Contact information
Practice address
800 BIESTERFIELD RD, SUITE 4005, ELK GROVE VILLAGE, IL 60007-3361
(847) 593-4116
(847) 593-4135
Mailing address
4400 W 95TH ST STE 308, OAK LAWN, IL 60453-2660
(708) 346-4040
(708) 346-3287
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036078229
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078229
—
IL
Enumeration date
06/01/2005
Last updated
12/15/2021
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