Healthcare Provider Details

I. General information

NPI: 1629603816
Provider Name (Legal Business Name): DANIEL PATRICK MCKEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2020
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 WEST ST
PERU IL
61354-2757
US

IV. Provider business mailing address

925 WEST ST
PERU IL
61354-2757
US

V. Phone/Fax

Practice location:
  • Phone: 815-221-0330
  • Fax: 815-221-0331
Mailing address:
  • Phone: 815-221-0330
  • Fax: 815-221-0331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number036180090
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number036180090
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number82431-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: