Individual provider · Type 1 NPI

Keith Michael Ladendorf, PA-C

Surgical Physician Assistant · Chicago, IL

NPI number 1619092095 Active

Practice location

7447 W Talcott Avenue, Suite 512
Chicago, IL 60631

Fax (773) 577-8187

Mailing address

2650 Warrenville Road, Suite 280
Downers Grove, IL 60515

Other practice locations

  • 3900 St Francis Way Ste 200, Lafayette, IN 47905-4940 · (776) 775-2800

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X085002545 (IL)
Surgical Physician Assistant 363AS0400X085-002545 (IL)

Surgical Physician Assistant: Definition to come...

5 other providers at this address

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About NPI 1619092095

Keith Michael Ladendorf, PA-C's National Provider Identifier is 1619092095, issued on Mar 21, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Chicago, IL. The record was last updated on Jan 23, 2023.