NPI 1043105836

Samuel B Keidan

Practitioner Behavior Technician Elmhurst, IL

Practice location

Address: 121 N Addison Ave, Elmhurst, IL 60126-2809
Phone: (877) 486-4140
Mailing address: 755 Bonnie Brae Pl, River Forest, IL 60305-1930

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X

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Registry record

NPI: 1043105836
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Jun 2025
Record last updated: 11 Jun 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.