Individual
BRETT L. KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1505 EASTLAND DR, SUITE 220, BLOOMINGTON, IL 61701-3534
(309) 662-2278
(309) 663-2956
Mailing address
1505 EASTLAND DR, SUITE 220, BLOOMINGTON, IL 61701-3534
(309) 662-2278
(309) 663-2956
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036110898
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0361100898
OSF CARE ADVANTAGE
IL
01
—
036110898
UNITED HEALTHCARE
IL
05
—
036110898 1
—
IL
01
—
1302850001
ADMINISTAR FEDERAL
IL
01
—
133229700
US DEPARTMENT OF LABOR
IL
01
—
5715378
BLUE CROSS BLUE SHIELD
IL
01
—
678434
HEALTHLINK
IL
01
—
IL0103
JOHN DEERE HEALTH
IL
01
—
P00200415
MEDICARE METRAHEALTH
IL
Enumeration date
07/27/2006
Last updated
10/04/2022
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