Provider Demographics
NPI:1588436786
Name:KEEFE-DAGUINSIN, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:KEEFE-DAGUINSIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 STONEGATE RD
Mailing Address - Street 2:
Mailing Address - City:TROUT VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-2524
Mailing Address - Country:US
Mailing Address - Phone:181-552-9593
Mailing Address - Fax:
Practice Address - Street 1:649 BARRON BLVD UNIT 3
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1301
Practice Address - Country:US
Practice Address - Phone:815-200-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor