MRS. TRACI LYNNE KEYSTER (NPI# 1255684072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255684072 |
| Entity Type | Individual |
| Full Name | MRS. TRACI LYNNE KEYSTER |
| Credential | FNP |
| Practice Address |
611 W Jefferson St Shorewood IL 60404-3772 |
| Practice Telephone | 8157291144 |
| Mailing Telephone | 8157291144 |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209009868 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
611 W JEFFERSON ST |
| City | SHOREWOOD |
| State | IL |
| Zip Code | 60404-3772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689637555 | Spomenka Jercinovic | Pediatrics | 611 W Jefferson St, Shorewood, IL 60404-3772 | 2006-04-10 |
| 1548348501 | Lesley J Widmer | Counselor | 611 W Jefferson St, Shorewood, IL 60404-3772 | 2006-11-01 |
| 1043273915 | Bruno John Jercinovic | Pediatrics | 611 W Jefferson St, Shorewood, IL 60404-3772 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669035242 | Mobile Dental Care of Delaware, Pa | Dentist | 18622 S. Rte 59 Unit A-1, Shorewood, IL 60404 | 2019-04-18 |
| 1326476755 | Christine Briski | Speech-Language Pathologist | 210 W Black Road, Shorewood, IL 60404 | 2013-10-22 |
| 1598000630 | Michael G Mcdowell | Nurse Practitioner | 1039 Brookforest Ave, Shorewood, IL 60404 | 2012-11-29 |
| 1699028910 | Patti-ann Ebert | Occupational Therapist | 850 Brook Forest Ave., Unit L, Shorewood, IL 60404 | 2012-10-24 |
| 1043567720 | Matthew Reiot Klebenow | Occupational Therapist | 852a Sharp Drive, Provena Physical Therapy & Industrial Rehab. Center, Shorewood, IL 60404 | 2012-08-13 |
| 1366728222 | Linda K Alonso | Pharmacist | 1160 W. Jefferson St., Shorewood, IL 60404 | 2011-10-24 |
| 1205110186 | Lanie R Moreno | Physical Therapist | 850 Brookforest Ave Unit L, Shorewood, IL 60404 | 2011-10-10 |
| 1932386810 | Advanced Family Dental of Shorewood, P.C. | Dentist | 150 N Brook Forest Drive, Shorewood, IL 60404 | 2008-01-23 |
| 1003025941 | Kerri Lanum | Specialist/Technologist | 850 Brookforest Ave. F, Shorewood, IL 60404 | 2007-05-21 |
| 1124246756 | Alexander Grabavoy | Dentist | 1007 W. Jefferson Street, Shorewood, IL 60404 | 2007-04-20 |
| Find all providers in zip 60404 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992153860 | Keni O. Jegede | Nurse Practitioner | 21135 S Meadowview Ln, Shorewood, IL 60404-8368 | 2016-06-01 |
| 1942636881 | Kimberly Ann Gill | Nurse Practitioner | 1704 Fieldstone Dr S, Shorewood, IL 60404-7403 | 2013-09-24 |
| 1598000630 | Michael G Mcdowell | Nurse Practitioner | 1039 Brookforest Ave, Shorewood, IL 60404 | 2012-11-29 |
| 1356985329 | Jillian Michelle Weglarz | Nurse Practitioner | 1155 W Jefferson St, Shorewood, IL 60404-0701 | 2019-11-03 |
| 1598154247 | Mary Kluever | Nurse Practitioner | 850 Brook Forest Ave, Unit Q, Shorewood, IL 60404-8513 | 2015-01-19 |
| 1831588979 | Jayison Mccorkle | Nurse Practitioner | 850 Brook Forest Ave, Shorewood, IL 60404-8513 | 2015-01-13 |
| 1801228580 | April D Kubinski | Nurse Practitioner | 1039 Brookforest Ave, Shorewood, IL 60404-8849 | 2013-08-05 |
| 1417397050 | Amy Vertin | Nurse Practitioner | 1039 Brookforest Ave, Shorewood, IL 60404-8849 | 2013-06-27 |
| 1821348129 | Cheryl Patrice Harris | Nurse Practitioner | 1155 W Jefferson St, Shorewood, IL 60404-0701 | 2012-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760277 | Jennifer Michelle Kennedy | Nurse Practitioner | 3006 Lakeview Dr, Metropolis, IL 62960-3119 | 2020-11-07 |
| 1881295541 | Britney Julia Durst | Nurse Practitioner | 5905 N Prospect Rd, Peoria, IL 61614-4311 | 2020-11-07 |
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1598365140 | Caitlyn Windsor | Nurse Practitioner | 24525 Grange Rd, Geneseo, IL 61254-8429 | 2020-10-31 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1346840337 | Catherine Suh | Nurse Practitioner | 1380 Marcy Ln, Wheeling, IL 60090-4422 | 2020-10-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.