Provider Demographics
NPI:1720891690
Name:BURCHFIELD, KEELIN
Entity type:Individual
Prefix:
First Name:KEELIN
Middle Name:
Last Name:BURCHFIELD
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 1:2548 WATERBURY DR APT 2106
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-4258
Mailing Address - Country:US
Mailing Address - Phone:331-457-0542
Mailing Address - Fax:
Practice Address - Street 1:1108 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-1362
Practice Address - Country:US
Practice Address - Phone:630-620-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health