Individual
DORA KEINATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
103 JIM CT, EAST PEORIA, IL 61611-4738
(309) 369-8983
Mailing address
103 JIM CT, EAST PEORIA, IL 61611-4738
(309) 369-8983
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
041-441206
IL
163WI0600X
Infection Control Registered Nurse
041-441206
IL
Other
Enumeration date
01/11/2021
Last updated
01/11/2021
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