Provider Demographics
NPI:1992772289
Name:KEE, DAVID LOUIS (DPM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LOUIS
Last Name:KEE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14160 JAMESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BREESE
Mailing Address - State:IL
Mailing Address - Zip Code:62230-3694
Mailing Address - Country:US
Mailing Address - Phone:618-526-7154
Mailing Address - Fax:
Practice Address - Street 1:14160 JAMESTOWN RD
Practice Address - Street 2:
Practice Address - City:BREESE
Practice Address - State:IL
Practice Address - Zip Code:62230-3694
Practice Address - Country:US
Practice Address - Phone:618-526-7154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-05
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000768213ES0103X
IL016-004886213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
57597OtherGHP
IL2700500OtherUHC
IL480026529OtherMEDICARE RAILROAD PTAN
IL483960OtherGROUP
IL5370680OtherAETNA
IL2700500OtherUHC
IL5370680OtherAETNA