Provider Demographics
NPI:1619775913
Name:MCKAY, MCKENZIE (PHARMD)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:MCKAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:858 N IRELAND LN
Mailing Address - Street 2:
Mailing Address - City:BELLE RIVE
Mailing Address - State:IL
Mailing Address - Zip Code:62810-3709
Mailing Address - Country:US
Mailing Address - Phone:618-327-6709
Mailing Address - Fax:
Practice Address - Street 1:1071 W BROADWAY
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:IL
Practice Address - Zip Code:62801-5309
Practice Address - Country:US
Practice Address - Phone:618-532-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051306486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist