Individual
MR. DALE T MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1025 S 6TH ST, SPRINGFIELD, IL 62703
(217) 528-7541
(217) 210-9662
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-002547
IL
Other
Enumeration date
10/03/2006
Last updated
05/21/2020
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