Individual
MACKIE A SNEBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3920 N JOHNSBURG RD, JOHNSBURG, IL 60051-6320
(815) 344-0088
(815) 363-3477
Mailing address
3920 N JOHNSBURG RD, JOHNSBURG, IL 60051-6320
(815) 344-0088
(815) 363-3477
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036067812
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360678124
—
IL
01
—
05615148
BCBS
IL
Enumeration date
12/28/2006
Last updated
02/12/2020
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