Individual
JILL MARIE KEREKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
584 ROOSEVELT TRL, WINDHAM, ME 04062-7302
(207) 892-3233
(207) 893-0752
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD17649
ME
208000000X
Pediatrics Physician
MD17649
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200802
ANTHEM
ME
05
—
30208309
—
NH
05
—
432827099
—
ME
Enumeration date
07/26/2006
Last updated
08/15/2012
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