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Individual

ILENE KEIVEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
425 GRAPE VINE TRL, OSWEGO, IL 60543-6036
(630) 551-3006
Mailing address
425 GRAPE VINE TRL, OSWEGO, IL 60543-6036

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
96001986
IL

Other

Enumeration date
03/09/2007
Last updated
07/08/2007
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