Individual
KEETON PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
4846 N CLARK ST STE 100, CHICAGO, IL 60640-7925
(312) 574-0750
Mailing address
4846 N CLARK ST STE 100, CHICAGO, IL 60640-7925
(773) 217-8819
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.104928
IL
Other
Enumeration date
02/01/2021
Last updated
06/14/2025
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