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General NPI Number Information
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NPI Number | 1144425463
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Entity Type | Organization
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Legal Business Name | MCNULTY CONSULTANTS, INC
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 10/14/2008
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Provider Practice Location Address
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Address Line | 125 E LAKE ST STE 206
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1117
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Country | US
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Telephone | 630-673-5510
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Fax |
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Provider Business Mailing Address
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Address Line | 1N270 ELLIS AVE
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City | CAROL STREAM
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State | IL
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Zip | 60188-3543
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Country | US
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Telephone | 630-673-5510
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PAUL R. MCNULTY
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Credential | LCSW
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Telephone | 630-673-5510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149004338
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License Number State | IL
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