Provider Demographics
NPI:1427237536
Name:O'KEEFE, GERALD (PHD)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:O'KEEFE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5845 N SAINT JOHNS CT
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-6048
Mailing Address - Country:US
Mailing Address - Phone:773-205-7613
Mailing Address - Fax:773-205-7613
Practice Address - Street 1:5845 N SAINT JOHNS CT
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-6048
Practice Address - Country:US
Practice Address - Phone:773-205-7613
Practice Address - Fax:773-205-7613
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist