Individual
MICHAEL GENIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
350 W CARPENTER ST, SPRINGFIELD, IL 62702-4902
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085005502
IL
Other
Enumeration date
09/02/2015
Last updated
05/22/2020
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