Healthcare Provider Details

I. General information

NPI: 1568436566
Provider Name (Legal Business Name): JULIE C OKEEFE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 S 1ST AVE ( 1950 S. HARLEM AVE, NO RIVERSIDE, IL. 60546)
MAYWOOD IL
60153
US

IV. Provider business mailing address

2160 S 1ST AVE ( 1950 S. HARLEM AVE, NO RIVERSIDE, IL. 60546)
MAYWOOD IL
60153
US

V. Phone/Fax

Practice location:
  • Phone: 708-354-9250
  • Fax: 708-354-8765
Mailing address:
  • Phone: 708-354-9250
  • Fax: 708-354-8765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36100041
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: