Organization
HEALTH PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH O ROPER M.D, M.S (OWNER)
(312) 421-3434
Entity
Organization
Contact information
Practice address
19330 S COTTAGE GROVE AVE, GLENWOOD, IL 60425-1834
(708) 758-6200
Mailing address
1507 W POLK ST, CHICAGO, IL 60607-3120
(312) 421-3434
(312) 421-5237
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
036055359
IL
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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