Individual
KAREN T KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5841 S MARYLAND AVE, M1035, CHICAGO, IL 60637-1447
(773) 926-9116
Mailing address
180 HARVESTER DR, SUITE 110, BURR RIDGE, IL 60527-7594
(773) 702-1061
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209011228
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209011228
STATE OF ILLINOIS
IL
Enumeration date
01/21/2014
Last updated
04/04/2016
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