Individual
DR. ROBERT KENNETH MACNAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
330 NORTH MADISON STREET, SUITE 104, JOLIET, IL 60435
(815) 725-8400
(815) 725-8401
Mailing address
330 MADISON ST, SUITE 104, JOLIET, IL 60435-6565
(815) 725-8400
(815) 725-8401
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016-004436
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004436
—
IL
01
—
020484
HEALTH ALLIANCE
IL
01
—
0739010001
MEDICARE NSC
IL
01
—
0739010005
MEDICARE NSC
IL
01
—
0739010006
MEDICARE NSC
IL
01
—
0739010008
MEDICARE NSC
IL
01
—
3200053
BCBS
IL
01
—
480032274
RR MEDICARE
IL
01
—
CL7476
RAILROAD MEDICARE GROUP #
IL
Enumeration date
08/05/2006
Last updated
10/14/2015
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