Individual provider · Type 1 NPI
Timothy J. Menard, PA
Medical Physician Assistant · Kankakee, IL
NPI number
1861638306
Active
Practice location
3000 S Justice Way
Kankakee, IL 60901-8449
Mailing address
555 W Court St Ste 410
Kankakee, IL 60901-3675
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 085-000584 (IL) |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Kankakee
About NPI 1861638306
Timothy J. Menard, PA's National Provider Identifier is 1861638306, issued on Jan 6, 2009. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Kankakee, IL. The record was last updated on Jan 6, 2009.