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Individual
MR. KEITH E. BALLINGER
Active
Individual
MR. KEITH E. BALLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
66690
CA
208800000X
Urology Physician
Primary
085001872
IL
363A00000X
Physician Assistant
Primary
085001872
IL
Other
Enumeration date
08/02/2006
Last updated
08/21/2026
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