Keith, Danielle M

Keith, Danielle M is an individual health care provider with primary practice located at 907 W Marketview Dr 15, Champaign IL 61822-1227. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Keith, Danielle M can be contacted via phone (217) 351-8822.

Contact Information

Primary practice address
907 W Marketview Dr 15 Champaign IL 61822-1227
Fax: (217) 351-8879
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046.010383 Illinois

Profile Details

NPI number 1699087361
LBN Legal business name Keith, Danielle M
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2010
Last updated Jan 11th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699087361 NPPES
Illinois MEDICAID 046010383

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