Kevan E Ketterling in Geneva - Sports Medicine
Kevan E Ketterling - NPI 1770563710
Kevan E Ketterling is a Sports Medicine in Geneva, Illinois. Kevan E Ketterling practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Kevan E Ketterling is 1770563710. The last update date is 2013-02-05.
Kevan E Ketterling's current location address is 2525 Kaneville Rd, Geneva, Illinois. You can contact this provider via phone number 6305841400 and fax number 6305841733. The mailing address for Kevan E Ketterling is 2525 Kaneville Rd, Geneva, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevan E Ketterling |
|---|---|
| Address | 2525 Kaneville Rd, Geneva, Illinois |
| Phone Number | 6305841400 |
| Fax Number | 6305841733 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1770563710 |
|---|---|
| Provider Enumeration Date | 2006-01-17 |
| Last Updated Date | 2013-02-05 |
Provider Mailing Address Detail
| Address | 2525 Kaneville Rd |
|---|---|
| City | Geneva |
| State | Illinois (IL) |
| Post Code | 601342578 |
| Phone Number | 6305841400 |
| Fax Number | 6305841733 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Xx0005X |
| Licence No | 36082353 |
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Definition: An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, train |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 141081 | IL | MEDICARE FACILITY | |
| CF2064 | IL | RAILROAD GROUP | |
| 200007873 | IL | RAILROAD MEDICARE | |
| 36082353 | IL | -- |
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What is the Kevan E Ketterling's 1770563710?
The Kevan E Ketterling's NPI (National Provider Identifier) Number is 1770563710. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
What is the Kevan E Ketterling's specialty and taxonomy code?
The Kevan E Ketterling's specialty is Sports Medicine, and the corresponding taxonomy code is 207Xx0005X.
On what date did the Centers for Medicare & Medicaid Services issue the 1770563710 to Kevan E Ketterling?
The Kevan E Ketterling received its 1770563710 assignment from the Centers for Medicare & Medicaid Services on 2006-01-17.
When was the Kevan E Ketterling's information last updated?
The Kevan E Ketterling's information was last updated on 2013-02-05.
When was the information pertaining to Kevan E Ketterling most recently updated or revised?
The details related to Kevan E Ketterling, including its address, specialty, and other relevant information, were last updated or revised on 2013-02-05.
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