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General NPI Number Information
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NPI Number | 1629292164
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Entity Type | Individual
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Provider Name | TERRI LYN MCCREEDY APN
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Gender | Female
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 555 PLAINFIELD RD SUITE B
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City | WILLOWBROOK
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State | IL
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Zip | 60527-7602
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Country | US
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Telephone | 630-887-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 6524 BRIARGATE DR
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-3016
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Country | US
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Telephone | 630-971-1750
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State | IL
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