Provider Demographics
NPI:1578797130
Name:KEUNG, CONNIE H (MD)
Entity Type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:H
Last Name:KEUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 DELNOR DR STE 400
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4228
Mailing Address - Country:US
Mailing Address - Phone:630-668-0833
Mailing Address - Fax:630-208-4373
Practice Address - Street 1:351 DELNOR DR STE 400
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4228
Practice Address - Country:US
Practice Address - Phone:630-668-0833
Practice Address - Fax:630-208-4373
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01077306A208600000X
IL036164188208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery