Healthcare Provider Details

I. General information

NPI: 1740927094
Provider Name (Legal Business Name): MARGARET ANNE COYLE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 W HARRISON ST
CHICAGO IL
60612-3800
US

IV. Provider business mailing address

2750 N KENMORE AVE APT 2F
CHICAGO IL
60614-1375
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-5000
  • Fax:
Mailing address:
  • Phone: 317-797-6290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number041424689
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number350925
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: