Nicole Christine Keller, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036129833 Issued in IL

Practice address

4789 Route 71
Oswego, IL 60543-7415

Phone

(630) 898-5969

Fax

(630) 898-5837

NPI assigned

Nov 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nkeller84195@direct.rush.rush-health.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rush Copley Medical Group

  • Family Medicine Physician
  • Aurora, IL
  • NPI 1194836247
  NPD (past)
• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1316214240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4789 ROUTE 71",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437415",
            "telephone_number": "630-898-5969",
            "fax_number": "630-898-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4789 ROUTE 71",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437415",
            "telephone_number": "630-898-5969",
            "fax_number": "630-898-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "NICOLE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-21",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036129833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anju Katyal, OTR/L
• Shivani Katyal, DO
• Laurie Kauzlaric, MS CCC SLP,M.ED.SPED
• Christina Marie Keilson
• Ilene Keivel
• Richard P Kelly, DO
• Kendall Pointe Dental LLC
• Kendall Pointe Surgery Center LLC
• Ryan Daniel Kent, FNP-BC FPA
• Jamee S Kerkman, LCPC

• Pediatrics Physician in Oswego, IL
• Providers in Oswego, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.