Provider Demographics
NPI:1760520357
Name:KEENAN-LOSTER, BARBARA (LAC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:KEENAN-LOSTER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 WILLIS ST
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-4244
Mailing Address - Country:US
Mailing Address - Phone:630-664-1089
Mailing Address - Fax:
Practice Address - Street 1:17W300 22ND ST
Practice Address - Street 2:SUITE 460
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4405
Practice Address - Country:US
Practice Address - Phone:630-664-1089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-03
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist