| Keith Destefano, LMT | |
|
320 High Ridge Rd, Hillside, IL 60162-1621 | |
| (708) 420-8923 | |
| Not Available |
| Full Name | Keith Destefano |
|---|---|
| Gender | Male |
| Speciality | Massage Therapist |
| Location | 320 High Ridge Rd, Hillside, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730596370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | 227013561 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Destefano, LMT 320 High Ridge Rd, Hillside, IL 60162-1621 Ph: (708) 420-8923 | Keith Destefano, LMT 320 High Ridge Rd, Hillside, IL 60162-1621 Ph: (708) 420-8923 |
Anna Kuczaj, Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 4413 Roosevelt Rd, Suite 100, Hillside, IL 60162 Phone: 708-449-5900 Fax: 708-499-5901 | |
Kisha Daniel, LMT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 4413 Roosevelt Rd Ste 100, Hillside, IL 60162 Phone: 773-425-1201 |