Provider Demographics
NPI:1578508354
Name:KLOPFENSTEIN, JEFFREY DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DAVID
Last Name:KLOPFENSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:719 N WILLIAM KUMPF BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61605-2530
Mailing Address - Country:US
Mailing Address - Phone:309-676-0766
Mailing Address - Fax:309-676-5920
Practice Address - Street 1:719 N WILLIAM KUMPF BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61605-2530
Practice Address - Country:US
Practice Address - Phone:309-676-0766
Practice Address - Fax:309-676-5920
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2014-09-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036114939174400000X
IL036-114939207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No174400000XOther Service ProvidersSpecialist