Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Katherine Kenney, PA

Individual provider Medical Physician Assistant · NPI 1003299082

Mary Katherine Kenney, PA is a Physician Assistant in Decatur, Illinois. Qualified in 2015, 11 years ago. Practices with Memorial Physician Services, a 158-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
11
Licensed in
IL
In the registry since
2015
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone: (217) 464-2966
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3131 N Water St, Decatur, IL 62526-2472 — (217) 876-5320

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 085005526 (IL)

Record details

NPI number1003299082
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 8, 2015
Last updated in NPPESDecember 13, 2023
Certification dateDecember 13, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Memorial Physician Services — 158 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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