Keith Robert Erickson | Springfield, IL • PECOS Search

Keith Robert Erickson

Counselor

Behavioral Health & Social Service Providers

2501 Chatham Road Suite N., Springfield, IL 62704

PECOS Enrollment

Based on the most recent information from CMS, provider Keith Robert Erickson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1134808868
Provider Type
Individual
Full Name
Erickson, Keith Robert
Gender
Male

Sole Proprietor
Yes
Enumeration Date
7/11/2023
Last Updated
7/11/2023

Contact Information

Practice Location

2501 Chatham Road Suite N., Springfield, IL 62704

Unlisted Fax

Mailing Location

1555 Sherman Ave Ste 216, Evanston, IL 60201-4421

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer