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General NPI Number Information
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NPI Number | 1467951731
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Entity Type | Individual
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Provider Name | DEVAN KEESLING AU.D, CCC-A
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Gender | Male
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 07/05/2018
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Provider Practice Location Address
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Address Line | 800 N WESTMORELAND RD STE LL30
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City | LAKE FOREST
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State | IL
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Zip | 60045
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Country | US
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Telephone | 847-535-6114
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Fax | 847-535-7809
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Provider Business Mailing Address
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Address Line | 462 W HALF DAY RD
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-6555
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 147.001660
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License Number State | IL
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