Healthcare Provider Details

I. General information

NPI: 1235052929
Provider Name (Legal Business Name): ANTINEY D MCKINNEY PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3416 S HALSTED ST
CHICAGO IL
60608-6708
US

IV. Provider business mailing address

2817 N 75TH AVE APT 1S
ELMWOOD PARK IL
60707-1632
US

V. Phone/Fax

Practice location:
  • Phone: 773-823-9434
  • Fax: 773-296-1097
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2025100518
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: