Provider Demographics
NPI:1356945042
Name:ASKEW, KEYSHA S (MSN FNP-C)
Entity type:Individual
Prefix:
First Name:KEYSHA
Middle Name:S
Last Name:ASKEW
Suffix:
Gender:F
Credentials:MSN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 FAIRWAY LN
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60484-2746
Mailing Address - Country:US
Mailing Address - Phone:708-323-7680
Mailing Address - Fax:
Practice Address - Street 1:500 W CENTRAL RD
Practice Address - Street 2:
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-2347
Practice Address - Country:US
Practice Address - Phone:847-376-8144
Practice Address - Fax:847-376-8597
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.019623363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily