Provider Demographics
NPI:1467529990
Name:MCENERNEY, JAMES KEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KEVIN
Last Name:MCENERNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-4818
Mailing Address - Country:US
Mailing Address - Phone:217-586-7077
Mailing Address - Fax:
Practice Address - Street 1:601 W PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-4818
Practice Address - Country:US
Practice Address - Phone:217-586-7077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-058926207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology