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Individual

KEENAN FERRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
5455 N SHERIDAN RD, 1709, CHICAGO, IL 60640-1958
(773) 944-5301
(773) 944-5302
Mailing address
5455 N SHERIDAN RD, 1709, CHICAGO, IL 60640-1958
(773) 944-5301
(773) 944-5302

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
00987
IA
103TC0700X
Clinical Psychologist
20041967A
IN
103TC0700X
Clinical Psychologist
Primary
IL

Other

Enumeration date
03/09/2007
Last updated
07/08/2007
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