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General NPI Number Information
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NPI Number | 1427713106
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Entity Type | Individual
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Provider Name | ADRIANE MCNEALY
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Gender | Female
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Dates
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Enumeration Date | 11/08/2021
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 230 W HURON ST STE 520
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City | CHICAGO
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State | IL
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Zip | 60654-3933
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Country | US
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Telephone | 312-818-2040
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Fax |
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Provider Business Mailing Address
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Address Line | 2701 S INDIANA AVE APT 2011
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City | CHICAGO
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State | IL
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Zip | 60616-2678
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Country | US
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Telephone | 177-356-2676
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 227015177
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License Number State | IL
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