Individual
MS. MEKENNA FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6140 N BROADWAY ST, CHICAGO, IL 60660-2538
(773) 435-9028
Mailing address
601 W JACKSON BLVD UNIT 803, CHICAGO, IL 60661-5641
(308) 850-2552
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.011483
IL
Other
Enumeration date
02/25/2025
Last updated
08/27/2025
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