MEDICARE: ANDREW BENEDICT O'KEEFE JR. DPM

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
1	213EP1101X	Primary Podiatric Medicine Podiatrist	016-004954	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00315818	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1208030001	OTHER	IL	DMERC
3	0001623503	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1669478640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW BENEDICT O'KEEFE JR. DPM

Provider Business Mailing Address
First Line	:	6374 N LINCOLN AVE
Second Line	:	STE 314
City	:	CHICAGO
State	:	IL
Zip	:	60659-1275
Country	:	US
Telephone Number	:	773-866-9800
Fax Number	:	773-866-1733

Provider Business Practice Location Address
First Line	:	6374 N LINCOLN AVE
Second Line	:	STE 314
City	:	CHICAGO
State	:	IL
Zip	:	60659-1275
Country	:	US
Telephone Number	:	773-866-9800
Fax Number	:	773-866-1733

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	03/02/2012

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Directions to “ ANDREW BENEDICT O'KEEFE JR. DPM” Practice Location

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