Individual
PETER S KIEFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 N 8TH ST STE 4A, SPRINGFIELD, IL 62701-1013
(217) 545-8000
(217) 545-2303
Mailing address
PO BOX 19658, SPRINGFIELD, IL 62794-9658
(217) 545-8000
(217) 545-2303
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-133827
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036133827
STATE LICENSE
IL
05
—
206686115
—
MO
Enumeration date
07/13/2006
Last updated
02/26/2018
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