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DEATRICE L KELLOGG MD
NPI 1023058484
Internal Medicine - Geriatric Medicine in Swansea, IL

Active since June 07, 2006
2661 N ILLINOIS ST, PMB 309, SWANSEA, IL 62226(618) 257-2029(618) 235-5371 Get Directions Write a Review

NPPES record last updated: September 17, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Deatrice L Kellogg Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEATRICE L KELLOGG MD (NPI 1023058484) is a healthcare organization registered as a geriatric medicine in Swansea, Illinois and active in the NPI registry since June 2006. The organization lists Deatrice Lumae Kellogg, Owner, as its authorized official.

NPPES Registry Identity

NPI1023058484
Entity TypeOrganization
Primary Taxonomy207RG0300X
Legal Business NameDEATRICE L KELLOGG MD
Location Address2661 N ILLINOIS ST, PMB 309Swansea, IL 62226-2316
Mailing Address2661 N Illinois St, Pmb 309Swansea, IL 62226-2316 · (618) 257-2029 · Fax (618) 235-5371
Phone(618) 257-2029
Fax(618) 235-5371
Organization SubpartNo
Authorized OfficialDeatrice Lumae KelloggOwner · (618) 257-2029
Enumeration DateJune 7, 2006
Last NPPES UpdateSeptember 17, 2008
✔ NPI 1023058484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
License✔ Licensed in IL · 036097679
Definition
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
2661 N ILLINOIS ST, Swansea, IL 62226
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Other Identifiers 3

Medicaid493905552IL
OtherDE5033Rr Medicare
Medicare PIN212557

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deatrice L Kellogg MD's NPI number?

The NPI number for Deatrice L Kellogg MD is 1023058484. It was assigned to this organization in the NPPES registry on June 7, 2006.

Where is Deatrice L Kellogg MD located?

Deatrice L Kellogg MD is located at 2661 N Illinois St Pmb 309, Swansea, IL 62226. The listed phone number is (618) 257-2029.

What is Deatrice L Kellogg MD's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

When was this NPI record last updated?

The NPPES record for Deatrice L Kellogg MD was last updated on September 17, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.