Provider Demographics
NPI:1013495019
Name:MCKEEVER HEALTH AND CLINICAL SERVICES, LLC
Entity type:Organization
Organization Name:MCKEEVER HEALTH AND CLINICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEEVER
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:313-729-9376
Mailing Address - Street 1:1050 HOLBROOK RD APT P
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-4514
Mailing Address - Country:US
Mailing Address - Phone:313-729-9376
Mailing Address - Fax:
Practice Address - Street 1:2713 FLOSSMOOR RD
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-1100
Practice Address - Country:US
Practice Address - Phone:708-719-1897
Practice Address - Fax:708-726-5249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-01
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008993103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty