Beverley L Ketel is a Surgery in Peoria, Illinois. Beverley L Ketel practices all healthcare services and medical treatments related to Surgery. The NPI Number for Beverley L Ketel is 1659402048. The last update date is 2008-12-11.
Beverley L Ketel's current location address is 200 E Pennsylvania Ave, Peoria, Illinois. You can contact this provider via phone number 3096768123 and fax number 3096768455. The mailing address for Beverley L Ketel is 200 E Pennsylvania Ave, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Beverley L Ketel |
|---|---|
| Address | 200 E Pennsylvania Ave, Peoria, Illinois |
| Phone Number | 3096768123 |
| Fax Number | 3096768455 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1659402048 |
|---|---|
| Provider Enumeration Date | 2007-03-08 |
| Last Updated Date | 2008-12-11 |
Provider Mailing Address Detail
| Address | 200 E Pennsylvania Ave |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616033089 |
| Phone Number | 3096768123 |
| Fax Number | 3096768455 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | 36051866 |
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Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 36051866 | IL | -- | |
| 20051363 | IL | BCBS | |
| 20051363 | IL | RAILROAD MEDICARE |
Post Comment/ Review Below
What is the unique provider identifier assigned to Beverley L Ketel?
The Beverley L Ketel has been issued the NPI (National Provider Identifier) 1659402048 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Beverley L Ketel is geographically located?
The Beverley L Ketel is physically situated at the following location: 200 E Pennsylvania Ave, Peoria, IL, 616033089.
What is Beverley L Ketel's area of expertise and its corresponding taxonomy classification?
The Beverley L Ketel's field of specialization is Surgery, and it falls under the taxonomy code 208600000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Beverley L Ketel receive the assignment of its 1659402048 from the Centers for Medicare & Medicaid Services?
The Beverley L Ketel was issued its 1659402048 by the Centers for Medicare & Medicaid Services on 2007-03-08.
As of what date were the Beverley L Ketel's details last updated?
The information pertaining to the Beverley L Ketel, including its address, specialty, and other details, was most recently updated on 2008-12-11.