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General NPI Number Information
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NPI Number | 1255771861
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Entity Type | Individual
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Provider Name | ERIK MCINTOSH RN, ACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 1650 W HARRISON ST SUITE 706 NORTH ATRIUM
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City | CHICAGO
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State | IL
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Zip | 60612-3800
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Country | US
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Telephone | 312-942-5025
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Fax |
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Provider Business Mailing Address
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Address Line | 400 N LA SALLE DR UNIT 3506
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City | CHICAGO
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State | IL
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Zip | 60654-8539
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Country | US
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Telephone | 773-316-5551
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209.010447
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209010447
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License Number State | IL
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