Healthcare Provider Details

I. General information

NPI: 1376070334
Provider Name (Legal Business Name): AMY MCLAUGHLIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2017
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E HURON ST STE 16-738
CHICAGO IL
60611-2908
US

IV. Provider business mailing address

251 E HURON ST STE 16-738
CHICAGO IL
60611-2908
US

V. Phone/Fax

Practice location:
  • Phone: 312-926-5924
  • Fax: 312-926-6134
Mailing address:
  • Phone: 312-926-5924
  • Fax: 312-926-6134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085006330
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: