Healthcare Provider Details

I. General information

NPI: 1154712743
Provider Name (Legal Business Name): DANICA B MCKAIN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANICA B KROEGER APN

II. Dates (important events)

Enumeration Date: 02/18/2015
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 FOUNDERS LN STE 100
JACKSONVILLE IL
62650-3924
US

IV. Provider business mailing address

15 FOUNDERS LN STE 100
JACKSONVILLE IL
62650-3924
US

V. Phone/Fax

Practice location:
  • Phone: 217-243-0300
  • Fax: 217-245-6775
Mailing address:
  • Phone: 217-243-0300
  • Fax: 217-245-6775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number277001667
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277001667
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: