Individual
MR. KEVIN CLANCY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4001 W DAYTON ST, MCHENRY, IL 60050-8377
(815) 759-7116
Mailing address
4001 W DAYTON ST, MCHENRY, IL 60050-8377
(815) 759-7116
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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