Individual
TIMOTHY J MENARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3000 S JUSTICE WAY, KANKAKEE, IL 60901-8449
(815) 802-0731
Mailing address
555 W COURT ST STE 410, KANKAKEE, IL 60901-3675
(815) 802-0731
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085-000584
IL
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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