Richard Loran Keller, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036078718 Issued in IL

Practice address

1738 Washington St
Waukegan, IL 60085-5137

Phone

(847) 360-1019

NPI assigned

Sep 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Illinois Medical Assistance Treatment Program LLC

  • Clinic/Center
  • Waukegan, IL
  • NPI 1407008998
  NPD (past) Authorized official

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232582400000",
    "number": "1437145141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 N ASH ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1738 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855137",
            "telephone_number": "847-360-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "RICHARD",
        "middle_name": "LORAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2009-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036078718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly A Kavanagh, LCSW
• Ellen Kawasaki, M.S. CF-SLP
• Jennifer Keel
• Murray J Keene, M.D.
• Courtney Kelbel
• Laurie Kelly, CADC
• Christine Sue Kemen, BSW
• Dana Josephine Kendall
• Glenn Kerr
• Carol Irene Kessel, PA-C

• Family Medicine Physician in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; 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.