Dana J Mackenzie

Individual provider Active NPI Social Worker · Mount Carroll, IL

NPI 1104447754 · NPPES record last updated May 5, 2020

Key facts

NPI
1104447754
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
Practice address
1126 Healthcare Dr
Mount Carroll, IL 61053-1469
Phone
(815) 244-4200
NPI assigned
May 5, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X IL Yes

Addresses

Primary practice location

1126 Healthcare Dr
Mount Carroll, IL 61053-1469

Mailing address

1126 Healthcare Dr
Mount Carroll, IL 61053-1469

Other providers in Mount Carroll, IL

All providers in Mount Carroll, IL · Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.