Individual
KEEGAN DUELFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2300 S 1ST ST, CHAMPAIGN, IL 61820-7661
(217) 383-9564
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2500
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016006010
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
POD-001042
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z276117
—
AZ
Enumeration date
09/01/2018
Last updated
02/20/2024
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