MEDICARE: RENEE FAITH KEEFER PT

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
1	225100000X	Physical Therapist	070018645	IL

General Provider Information

NPI Number	:	1821372038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE FAITH KEEFER PT

Provider Business Mailing Address
First Line	:	1347 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3208
Country	:	US
Telephone Number	:	773-360-1740
Fax Number	:	312-380-0464

Provider Business Practice Location Address
First Line	:	1347 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3208
Country	:	US
Telephone Number	:	773-360-1740
Fax Number	:	312-380-0464

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2011
Last Update Date	:	10/12/2022

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