Healthcare Provider Details

I. General information

NPI: 1013841949
Provider Name (Legal Business Name): HANNAH KEISKER LCPC, MED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 N CALIFORNIA AVE
CHICAGO IL
60647-5105
US

IV. Provider business mailing address

1803 N CALIFORNIA AVE
CHICAGO IL
60647-5105
US

V. Phone/Fax

Practice location:
  • Phone: 312-620-0408
  • Fax:
Mailing address:
  • Phone: 872-225-0331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: