Individual
MICHAEL KEEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
101 S MAJOR ST, EUREKA, IL 61530-1246
(309) 304-2004
(309) 467-2880
Mailing address
101 S MAJOR ST, EUREKA, IL 61530-1246
(309) 304-2004
(309) 467-2880
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209007640
IL
390200000X
Student in an Organized Health Care Education/Training Program
041-343146
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE
IL
Enumeration date
06/09/2009
Last updated
03/05/2024
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