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General NPI Number Information
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NPI Number | 1013495019
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Entity Type | Organization
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Legal Business Name | MCKEEVER HEALTH AND CLINICAL SERVICES, LLC
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Dates
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Enumeration Date | 08/01/2018
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 2713 FLOSSMOOR RD
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City | FLOSSMOOR
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State | IL
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Zip | 60422-1100
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Country | US
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Telephone | 708-719-1897
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Fax | 708-726-5249
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Provider Business Mailing Address
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Address Line | 1050 HOLBROOK RD APT P
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City | HOMEWOOD
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State | IL
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Zip | 60430-4514
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Country | US
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Telephone | 313-729-9376
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. KELLEY MCKEEVER
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Credential | PSY D
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Telephone | 313-729-9376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.008993
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License Number State | IL
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