Healthcare Provider Details
I. General information
NPI: 1336121920
Provider Name (Legal Business Name): ALAN R MCCALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 11/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7447 W TALCOTT AVE STE 500, NORTHWEST ORTHOPAEDIC ASSOCIATES LTD
CHICAGO IL
60631-3745
US
IV. Provider business mailing address
7447 W TALCOTT AVE STE 500, NORTHWEST ORTHOPAEDIC ASSOCIATES LTD
CHICAGO IL
60631-3745
US
V. Phone/Fax
- Phone: 773-631-7898
- Fax: 773-631-3005
- Phone: 773-631-7898
- Fax: 773-631-3005
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: