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Organization
MAYCLARE II LTD
Active
Organization
MAYCLARE II LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL P HONAN M.D. (PHYSICIAN)
(309) 347-9709
Entity
Organization
Contact information
Practice address
3223 GRIFFIN AVE, PEKIN, IL 61554
(309) 347-9709
(309) 347-1719
Mailing address
3223 GRIFFIN AVE, PEKIN, IL 61554-6214
(309) 347-9709
(309) 347-1719
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA4767
RAIL ROAD MEDICARE GROUP
IL
Enumeration date
11/13/2006
Last updated
04/14/2008
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