Provider Demographics
NPI:1861853780
Name:MCKINNIE, CARA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CARA
Middle Name:
Last Name:MCKINNIE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 PHILO RD
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61802-8044
Mailing Address - Country:US
Mailing Address - Phone:217-365-5210
Mailing Address - Fax:
Practice Address - Street 1:2500 PHILO RD
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61802-8044
Practice Address - Country:US
Practice Address - Phone:217-365-5210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-20
Last Update Date:2016-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.292096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist