Mcconkey, Isha L

Mcconkey, Isha L is an individual health care provider with primary practice located at 390 Maple Summit Rd Illini Bldg, Jerseyville IL 62052. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Mcconkey, Isha L can be contacted via phone (618) 498-2101.

Contact Information

Primary practice address
390 Maple Summit Rd Illini Bldg Jerseyville IL 62052
Phone: (618) 498-2101
Fax: (618) 498-8153
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036158038 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34.011181 Ohio

Profile Details

NPI number 1952693707
LBN Legal business name Mcconkey, Isha L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2011
Last updated Oct 7th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952693707 NPPES
Illinois Other 376013958 IRS
Illinois MEDICAID 0115016 IRS

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