NPIMap

Individual provider Active NPI

Matthew S. Keene, DPM

  • Primary Podiatric Medicine Podiatrist
  • Rockford, IL
National Provider Identifier
1508967621
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
016005216 Issued in IL
Practice address
4777 East State Street
Suite 8
Rockford, IL 61108
Phone
(815) 980-8980
Fax
(815) 397-2266
NPI assigned
Sep 25, 2006
Last updated
May 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016005216 IL
Primary Podiatric Medicine Podiatrist 213EP1101X 016005216 IL Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 016005216 IL

Addresses

Primary practice location

4777 East State Street
Suite 8
Rockford, IL 61108

Mailing address

4777 East State Street
Suite 8
Rockford, IL 61108
Phone (815) 980-8980

Other practice location 1

1801 W Taylor St
Chicago, IL 60612-4795
Phone (312) 996-7416

Other identifiers 2

IdentifierTypeStateIssuer
016005216MedicaidIL
010132351OtherILILLINOIS BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061011000642 IL Practitioner - Podiatry 1355347576 Reassigns benefits to 3 organizations
Practice locations: Rockford, IL
O20100930008525 IL DME Supplier - Physician - Podiatry 8820295090 Practice locations: Rockford, IL

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians
Saint Anthony Medical CenterGroup PAC ID 5496654006, 45 clinicians

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232

1801 W Taylor St
Chicago, IL 60612-4795

4777 E State St
Suite 8
Rockford, IL 61108-2256
Phone (815) 980-8980

5666 E State St
Rockford, IL 61108-2425
Phone (815) 921-8929

5668 E State St
Suite 400
Rockford, IL 61108-2490
Phone (815) 398-7755

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

901 S Walcott St
Uic Orthopedic Sports Medicine
Chicago, IL 60612-3725
Phone (312) 996-7161

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue668
Removal of skin lesions1-10
Removal of nail tissue26
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016005216ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jun 27, 2012 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Saint Anthony Medical Center CurrentSince Nov 28, 2023 Accepting new patients
The Board of Trustees of the University of Illinois Podiatrist CurrentSince Jun 27, 2012 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Oct 1, 2024 Accepting new patients
Foot Mechanics of Lake County, P.C. Podiatrist PastSince Jul 1, 2007 Accepting new patients
Camilleri Medical Center LTD Podiatrist PastSince Jan 1, 1999 Accepting new patients
Saint Anthony Medical Center Past Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients

Locations

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

901 S Wolcott Ave
Chicago, IL 60612
Phone (312) 996-3470

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

5668 E State St
Ste 400
Rockford, IL 61108
Phone (815) 398-7755

Interoperability endpoints

  • Direct secure messaging: mkeene17163@uihealth.direct-ci.com

Organizations & group practices 11

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1508967621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4777 EAST STATE STREET",
            "address_2": "SUITE 8",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61108",
            "telephone_number": "815-980-8980",
            "fax_number": "815-397-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4777 EAST STATE STREET",
            "address_2": "SUITE 8",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61108",
            "telephone_number": "815-980-8980",
            "fax_number": "815-397-2266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124795",
            "country_code": "US",
            "telephone_number": "312-996-7416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENE",
        "first_name": "MATTHEW",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016005216",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IL",
            "license": "016005216",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005216",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005216",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS BLUE CROSS",
            "identifier": "010132351",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.