MEDICARE: ADRIANE MCNEALY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	227015177	IL

General Provider Information

NPI Number	:	1427713106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANE MCNEALY

Provider Business Mailing Address
First Line	:	2701 S INDIANA AVE APT 2011
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-2678
Country	:	US
Telephone Number	:	177-356-2676
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 W HURON ST STE 520
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-3933
Country	:	US
Telephone Number	:	312-818-2040
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2021
Last Update Date	:	11/08/2021

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Directions to “ ADRIANE MCNEALY ” Practice Location

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