Individual
KEVIN M. JEFFRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
336 FRONT ST, GALVA, IL 61434-1365
(309) 932-3101
(309) 932-3154
Mailing address
336 FRONT ST, GALVA, IL 61434-1365
(309) 932-3101
(309) 932-3154
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036090015
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090015
—
IL
Enumeration date
05/04/2006
Last updated
10/26/2007
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