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Individual

DOUG R MCKAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, FNP-C

Contact information

Practice address
15 FOUNDERS LN, JACKSONVILLE, IL 62650
(217) 243-0300
(217) 245-0675
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(800) 577-5368
(217) 757-2021

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209019610
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041408623
RN LICENSE
IL
01
9999
PRIVATE INSURANCE
IL
Enumeration date
07/11/2019
Last updated
11/25/2019
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