Provider Demographics
NPI:1821372038
Name:KEEFER, RENEE FAITH (PT)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:FAITH
Last Name:KEEFER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:F
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1347 W BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3208
Mailing Address - Country:US
Mailing Address - Phone:773-360-1740
Mailing Address - Fax:312-380-0464
Practice Address - Street 1:1347 W BELMONT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3208
Practice Address - Country:US
Practice Address - Phone:773-360-1740
Practice Address - Fax:312-380-0464
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018645225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist