Healthcare Provider Details

I. General information

NPI: 1972223840
Provider Name (Legal Business Name): ADAM J MCCUE AGACNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E HURON ST
CHICAGO IL
60611-3055
US

IV. Provider business mailing address

7231 N SHERIDAN RD APT 3
CHICAGO IL
60626-2652
US

V. Phone/Fax

Practice location:
  • Phone: 312-926-2000
  • Fax:
Mailing address:
  • Phone: 815-325-4557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number041431695
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: