Individual
MRS. KYLIE L MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
351 DELNOR DR #100, GENEVA, IL 60134
(630) 262-1001
(630) 262-8065
Mailing address
351 DELNOR DR #100, GENEVA, IL 60134
(630) 262-1001
(630) 262-8065
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004411
IL
363AM0700X
Medical Physician Assistant
085.004411
IL
Other
Enumeration date
10/16/2012
Last updated
02/19/2019
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