Healthcare Provider Details

I. General information

NPI: 1194635953
Provider Name (Legal Business Name): NORTH SHORE MATERNAL & CHILD MEDICAL GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 N HIAWATHA AVE STE 260
CHICAGO IL
60646-4314
US

IV. Provider business mailing address

6200 N HIAWATHA AVE STE 260
CHICAGO IL
60646-4314
US

V. Phone/Fax

Practice location:
  • Phone: 847-220-4192
  • Fax:
Mailing address:
  • Phone: 847-220-4192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: KATIE MCCABE
Title or Position: PRESIDENT
Credential: MD, FAAP
Phone: 313-682-0631