Individual
ANDREW KETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1304 FRANKLIN AVE, NORMAL, IL 61761-3558
(309) 454-1400
Mailing address
1304 FRANKLIN AVE, NORMAL, IL 61761-3558
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036147094
IL
207Q00000X
Family Medicine Physician
125.066384
IL
Other
Enumeration date
05/19/2015
Last updated
08/28/2018
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