Individual
MARY KEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
26W171 ROOSEVELT RD, WHEATON, IL 60187-6078
(630) 909-7337
(630) 909-7039
Mailing address
26W171 ROOSEVELT RD, WHEATON, IL 60187-6078
(630) 909-7337
(630) 909-7039
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036.067113
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036067113
—
IL
Enumeration date
11/30/2006
Last updated
02/08/2018
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