Individual
DR. DANNY MACKENZIE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
146 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 249-5000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
125.080932
IL
208000000X
Pediatrics Physician
Primary
82000-21
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100331546
—
WI
Enumeration date
04/01/2022
Last updated
09/10/2025
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