Basic Information
| Provider Information | |||||||||
| NPI: | 1639595820 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KEEGAN | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 N CANAL ST | ||||||||
| Address2: | APT 1410 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606061236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042549538 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2401 RESEARCH BLVD STE 109 | ||||||||
| Address2: | |||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208503215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016575650 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2014 | ||||||||
| LastUpdateDate: | 03/21/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 070.020467 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | 2251X0800X | 870868 | DC | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.