Provider Demographics
NPI:1750347035
Name:KEEVEN, LEONARD JAMES SHAWN (MD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:JAMES SHAWN
Last Name:KEEVEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:600 JOHN DEERE RD
Mailing Address - Street 2:STE 404
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-6869
Mailing Address - Country:US
Mailing Address - Phone:309-779-3627
Mailing Address - Fax:309-779-4500
Practice Address - Street 1:600 JOHN DEERE RD
Practice Address - Street 2:STE 404
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6869
Practice Address - Country:US
Practice Address - Phone:309-779-3627
Practice Address - Fax:309-779-4500
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2015-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036115130207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP01079966OtherRR MEDICARE
IL200715008Medicare PIN