Healthcare Provider Details

I. General information

NPI: 1497765168
Provider Name (Legal Business Name): JUDITH H MCDEVITT PHD, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

734 W. 47TH STREET IHC SOUTH
CHICAGO IL
60609
US

IV. Provider business mailing address

845 S. DAMEN AVE. UIC COLLEGE OF NURSING (MC802) SUITE 912
CHICAGO IL
60612-7350
US

V. Phone/Fax

Practice location:
  • Phone: 312-536-8400
  • Fax: 773-536-2406
Mailing address:
  • Phone: 312-996-9175
  • Fax: 312-996-7725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: