The Illinois Medical Assistance Treatment Program LLC
NPI #1407008998 in Waukegan, Illinois
Provider Information
- NPI Number
- 1407008998
- Entity Type
- Organization
- Organization Name
- The Illinois Medical Assistance Treatment Program LLC
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Oct 16, 2008
- Last Updated
- Oct 16, 2008
Practice Location
Authorized Official
- Name
- DR. RICHARD L KELLER
- Title
- MEDICAL DIRECTOR
- Phone
- (847) 360-1019
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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