Individual
ERIN JEAN KEECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1457 WHITE OAK DR, CHASKA, MN 55318-2525
(952) 368-3800
Mailing address
800 BIESTERFIELD RD, SUITE # 106, ELK GROVE VILLAGE, IL 60007-3372
(847) 981-8866
(847) 981-5580
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12422
MN
363AM0700X
Medical Physician Assistant
085.002860
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085.002860
STATE LICENSE NO.
IL
01
—
12422
STATE LICENSE NUMBER
MN
Enumeration date
03/30/2007
Last updated
10/31/2018
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