Provider Demographics
NPI:1255680252
Name:KEIGHER, MAUREEN ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:ELIZABETH
Last Name:KEIGHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 N 1000E RD
Mailing Address - Street 2:
Mailing Address - City:MELVIN
Mailing Address - State:IL
Mailing Address - Zip Code:60952-4069
Mailing Address - Country:US
Mailing Address - Phone:217-781-4422
Mailing Address - Fax:
Practice Address - Street 1:1270 N 1000E RD
Practice Address - Street 2:
Practice Address - City:MELVIN
Practice Address - State:IL
Practice Address - Zip Code:60952-4069
Practice Address - Country:US
Practice Address - Phone:217-781-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist