Individual
EDWARD F MCKENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1471 KEOKUK ST, HAMILTON, IL 62341-1135
(217) 847-3383
(217) 847-2832
Mailing address
1471 KEOKUK ST, PO BOX 312, HAMILTON, IL 62341-1135
(217) 847-3383
(217) 847-2832
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036058009
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036058009
—
IL
05
—
0948398
—
IA
Enumeration date
11/22/2005
Last updated
07/14/2008
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