Healthcare Provider Details

I. General information

NPI: 1427757897
Provider Name (Legal Business Name): MARIA A. MCCARTHY APN-CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2023
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE STE 5240
EVANSTON IL
60201-1700
US

IV. Provider business mailing address

2650 RIDGE AVE STE 5240
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-1503
  • Fax: 847-733-5247
Mailing address:
  • Phone: 847-570-1503
  • Fax: 847-733-5247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209004221
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number209004221
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number209004221
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: