Individual
DR. MATTHEW S. KEENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4777 EAST STATE STREET, SUITE 8, ROCKFORD, IL 61108
(815) 980-8980
(815) 397-2266
Mailing address
4777 EAST STATE STREET, SUITE 8, ROCKFORD, IL 61108
(815) 980-8980
(815) 397-2266
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016005216
IL
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
016005216
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
016005216
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010132351
ILLINOIS BLUE CROSS
IL
05
—
016005216
—
IL
Enumeration date
09/25/2006
Last updated
05/16/2025
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