Healthcare Provider Details

I. General information

NPI: 1144436031
Provider Name (Legal Business Name): JEFFREY BRUCE MCKEEVER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JEFFREY BRUCE MCKEEVER M.D.

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1944 WEST BELLE PLAINE
CHICAGO IL
60614-1829
US

IV. Provider business mailing address

1944 WEST BELLE PLAINE
CHICAGO IL
60614-1829
US

V. Phone/Fax

Practice location:
  • Phone: 773-528-8992
  • Fax:
Mailing address:
  • Phone: 773-528-8992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: