Search › Illinois › 1223G0001X
Kenneth Myracle, D.M.D
NPI 1588862254 · on the registry since 2007 · sole proprietor
Practice
- Address
- 700 Broadway Ave E
Mattoon, IL 61938 - Phone
- (217) 235-1101
- Organisation at this address
- Community Health Improvement Center
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 1223G0001X
1223G0001X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois