Individual
ZACHARY H MCKENTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
300 W OAK ST, CARBONDALE, IL 62901-1400
(618) 453-8850
Mailing address
3736 PARADOR DR, NAPERVILLE, IL 60564-3109
(630) 918-0603
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
—
—
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/26/2012
Last updated
06/10/2020
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