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NPI Code Detail

MEDICARE: PETER S KIEFFER M.D.

MEDICARE:   PETER S KIEFFER  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician036-133827IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2036133827OTHERILSTATE LICENSE

General Provider Information

NPI Number : 1639194053
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER S KIEFFER M.D.
Provider Business Mailing Address
First Line : PO BOX 19658
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62794-9658
Country : US
Telephone Number : 217-545-8000
Fax Number : 217-545-2303
Provider Business Practice Location Address
First Line : 301 N 8TH ST STE 4A
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62701-1013
Country : US
Telephone Number : 217-545-8000
Fax Number : 217-545-2303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 02/26/2018

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Directions to “ PETER S KIEFFER M.D.” Practice Location

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