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NPI Code Detail

MEDICARE: J PAUL OKEEFE MD

MEDICARE: J PAUL OKEEFE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0200XInfectious Disease Physician36047253IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386621647
Entity Type Code : Individual
Provider Name (Legal Business Name) : J PAUL OKEEFE MD
Provider Business Mailing Address
First Line : 2160 S 1ST AVE
Second Line : (1950 S. HARLEM AVE., NORTH RIVERSIDE, IL. 60546)
City : MAYWOOD
State : IL
Zip : 60153
Country : US
Telephone Number : 708-354-9250
Fax Number : 708-354-8765
Provider Business Practice Location Address
First Line : 2160 S 1ST AVE
Second Line : (1950 S. HARLEM AVE., NORTH RIVERSIDE, IL. 60546)
City : MAYWOOD
State : IL
Zip : 60153
Country : US
Telephone Number : 708-354-9250
Fax Number : 708-354-8765
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 03/04/2010

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