Healthcare Provider Details

I. General information

NPI: 1831282086
Provider Name (Legal Business Name): PEARL CALLAGHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 N RANDALL RD
AURORA IL
60506
US

IV. Provider business mailing address

161 WASHINGTON ST EIGHT TOWER BRIDGE, SUITE 1400
CONSHOHOCKEN PA
19428
US

V. Phone/Fax

Practice location:
  • Phone: 866-825-3227
  • Fax: 484-351-3800
Mailing address:
  • Phone: 866-825-3227
  • Fax: 484-351-3800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: