Provider Demographics
NPI:1144436031
Name:MCKEEVER, JEFFREY BRUCE (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:BRUCE
Last Name:MCKEEVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JEFFREY
Other - Middle Name:BRUCE
Other - Last Name:MCKEEVER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1944 WEST BELLE PLAINE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1829
Mailing Address - Country:US
Mailing Address - Phone:773-528-8992
Mailing Address - Fax:
Practice Address - Street 1:1944 WEST BELLE PLAINE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1829
Practice Address - Country:US
Practice Address - Phone:773-528-8992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE24700Medicare UPIN