| Health Providers | |
|
19330 S Cottage Grove Ave Glenwood IL 60425-1834 | |
| (708) 758-6200 | |
| Not Available |
| Full Name | Health Providers |
|---|---|
| Speciality | Psychoanalyst |
| Location | 19330 S Cottage Grove Ave, Glenwood, Illinois |
| Authorized Official Name and Position | Keith O Roper (OWNER) |
| Authorized Official Contact | 3124213434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Providers 1507 W Polk St Chicago IL 60607-3120 Ph: (312) 421-3434 | Health Providers 19330 S Cottage Grove Ave Glenwood IL 60425-1834 Ph: (708) 758-6200 |
| NPI Number | 1891944484 |
|---|---|
| Provider Enumeration Date | 09/18/2008 |
| Last Update Date | 09/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891944484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 102L00000X | Psychoanalyst | 036055359 (Illinois) | Primary |
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