Provider Demographics
NPI:1447741756
Name:KEUPER, KEVIN (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:KEUPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E OGDEN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1296
Mailing Address - Country:US
Mailing Address - Phone:630-528-3215
Mailing Address - Fax:630-528-3219
Practice Address - Street 1:700 E OGDEN AVE STE 202
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1296
Practice Address - Country:US
Practice Address - Phone:630-528-3215
Practice Address - Fax:630-528-3219
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036156429207R00000X, 208M00000X
IL125.072126207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist