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General NPI Number Information
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NPI Number | 1194718742
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Entity Type | Organization
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Legal Business Name | JOSEPHINE N. MCCASKILL
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Dates
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Enumeration Date | 08/30/2005
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Last Update Date | 10/23/2009
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Provider Practice Location Address
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Address Line | 3153 E BENDING CREEK TRL
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City | CRETE
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State | IL
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Zip | 60417-3861
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Country | US
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Telephone | 773-640-7944
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Fax |
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Provider Business Mailing Address
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Address Line | 3153 E BENDING CREEK TRL PO BOX 545
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City | CRETE
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State | IL
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Zip | 60417-3861
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Country | US
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Telephone | 773-640-7944
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | JOSEPHINE MCCASKILL
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Credential | NP
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Telephone | 773-640-7944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 209004940
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 209004940
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License Number State | IL
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