Keller, Brett L.
Keller, Brett L. is an sole proprietor health care provider with primary practice located at 1505 Eastland Dr Suite 220, Bloomington IL 61701-3534. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Keller, Brett L. can be contacted via phone (309) 662-2278.Contact Information
Primary practice address
1505 Eastland Dr Suite 220
Bloomington IL 61701-3534
Phone: (309) 662-2278
Fax: (309) 663-2956
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 036110898 | Illinois |
Profile Details
| NPI number | 1407870876 |
|---|---|
| LBN Legal business name | Keller, Brett L. |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 27th, 2006 |
| Last updated | Oct 4th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407870876 | NPPES |
| Illinois | Other | 133229700 | US DEPARTMENT OF LABOR |
| Illinois | Other | 678434 | US DEPARTMENT OF LABOR |
| Illinois | Other | 0361100898 | US DEPARTMENT OF LABOR |
| Illinois | Other | 036110898 | US DEPARTMENT OF LABOR |
| Illinois | MEDICAID | 036110898 1 | US DEPARTMENT OF LABOR |
| Illinois | Other | 5715378 | US DEPARTMENT OF LABOR |
| Illinois | Other | 036110898 | US DEPARTMENT OF LABOR |
| Illinois | Other | 1302850001 | US DEPARTMENT OF LABOR |
| Illinois | Other | IL0103 | US DEPARTMENT OF LABOR |
| Illinois | Other | P00200415 | US DEPARTMENT OF LABOR |
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