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Individual

MARY KATHERINE KENNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 464-2966
Mailing address
3131 N WATER ST, DECATUR, IL 62526-2472
(217) 876-5320
(217) 876-5865

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085005526
IL

Other

Enumeration date
07/08/2015
Last updated
12/13/2023
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