Provider Demographics
NPI:1093418139
Name:KEYES, CASEY-JOHN ADRIAN (DO)
Entity Type:Individual
Prefix:DR
First Name:CASEY-JOHN
Middle Name:ADRIAN
Last Name:KEYES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 PLACITAS TRAILS RD
Mailing Address - Street 2:
Mailing Address - City:PLACITAS
Mailing Address - State:NM
Mailing Address - Zip Code:87043-9420
Mailing Address - Country:US
Mailing Address - Phone:303-242-1038
Mailing Address - Fax:
Practice Address - Street 1:820 S WOOD STREET
Practice Address - Street 2:MC 675
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-996-2933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.082710207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine