Organization Active NPI

Richard R. Keen, M.D., P.C.

  • Vascular Surgery Physician
  • Oak Brook, IL
National Provider Identifier
1174847032
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
036-074094 Issued in IL
Legal business name
RICHARD R. KEEN, M.D., P.C.
Practice address
2425 W 22ND St
Suite 211
Oak Brook, IL 60523-1247
Phone
(630) 575-8789
Fax
(630) 575-0720
NPI assigned
Mar 22, 2010
Last updated
Mar 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Richard R. Keen, M.D.
Title
President
Phone
(630) 575-8789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 036-074094 IL Primary

Addresses

Primary practice location

2425 W 22ND St
Suite 211
Oak Brook, IL 60523-1247

Mailing address

PO Box 608
Palos Park, IL 60464-0608
Phone (630) 575-8789

Other identifiers 1

IdentifierTypeStateIssuer
036074094MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269302400000",
    "number": "1174847032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 608",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604640608",
            "telephone_number": "630-575-8789",
            "fax_number": "630-575-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 W 22ND ST",
            "address_2": "SUITE 211",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231247",
            "telephone_number": "630-575-8789",
            "fax_number": "630-575-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD R. KEEN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-22",
        "last_updated": "2010-03-23",
        "status": "A",
        "authorized_official_last_name": "KEEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-575-8789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036-074094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036074094",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.