Individual provider Active NPI

Jill M Keller, DVM

  • Veterinarian
  • Downers Grove, IL
National Provider Identifier
1285078204
Registry record updated Apr 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
090009050 Issued in IL
Practice address
2551 Warrenville Rd
Downers Grove, IL 60515-1724
Phone
(630) 963-0424
NPI assigned
Apr 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 090009050 IL Primary

Addresses

Primary practice location

2551 Warrenville Rd
Downers Grove, IL 60515-1724

Mailing address

7511 Brown Ave
Unit E
Forest Park, IL 60130-3314
Phone (708) 366-1075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
090009050ILMDVeterinarian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366502400000",
    "number": "1285078204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7511 BROWN AVE",
            "address_2": "UNIT E",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601303314",
            "telephone_number": "708-366-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 WARRENVILLE RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151724",
            "telephone_number": "630-963-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JILL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-21",
        "last_updated": "2013-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "IL",
            "license": "090009050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.