Ladendorf, Keith Michael

Ladendorf, Keith Michael is an individual health care provider with primary practice located at 7447 W Talcott Avenue Suite 512, Chicago IL 60631. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Ladendorf, Keith Michael can be contacted via phone (847) 788-1553.

Contact Information

Primary practice address
7447 W Talcott Avenue Suite 512 Chicago IL 60631
Phone: (847) 788-1553
Fax: (773) 577-8187
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 085002545 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 085-002545 Illinois

Profile Details

NPI number 1619092095
LBN Legal business name Ladendorf, Keith Michael
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2007
Last updated Jan 23rd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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