Provider Demographics
NPI:1891833026
Name:O'KEEFE, JOHN FREEMAN (DDS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:FREEMAN
Last Name:O'KEEFE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NORTH VAN BUREN ST.
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959
Mailing Address - Country:US
Mailing Address - Phone:618-993-6616
Mailing Address - Fax:618-993-0857
Practice Address - Street 1:301 NORTH VAN BUREN ST.
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959
Practice Address - Country:US
Practice Address - Phone:618-993-6616
Practice Address - Fax:618-993-0857
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-138921223G0001X
IL019.0138921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice