Health Providers

Primary specialty

PsychoanalystTaxonomy code 102L00000X

License

036055359 Issued in IL

Legal business name

HEALTH PROVIDERS

Practice address

19330 S Cottage Grove Ave
Glenwood, IL 60425-1834

Phone

(708) 758-6200

NPI assigned

Sep 18, 2008

Organization subpart

No

Name

Dr. Keith O Roper, M.D, M.S

Title

Owner

Phone

(312) 421-3434

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 18, 2008.

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1891944484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 W POLK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073120",
            "telephone_number": "312-421-3434",
            "fax_number": "312-421-5237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19330 S COTTAGE GROVE AVE",
            "city": "GLENWOOD",
            "state": "IL",
            "postal_code": "604251834",
            "telephone_number": "708-758-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH PROVIDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "ROPER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-421-3434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D, M.S"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": "IL",
            "license": "036055359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenwood Healthcare & Rehab, Inc
• Glenwood Healthcare and Rehab
• Kenyetta Hall
• Denetra L Hardy, LPC
• Arteasia Harris, CNA
• Kayla Henry
• Vivian Diane Hudson-Davis, DEVELOPMENTAL THERAP
• Inspire Greatness Within, Inc.
• Ontonio Jackson-Lucas
• Gretchen Jackson

• All providers in Glenwood, IL
• Psychoanalyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; 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.