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General NPI Number Information
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NPI Number | 1750285201
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Entity Type | Organization
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Legal Business Name | MACLEOD SURGERY AND AESTHETICS LLC
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 3255 W EVERGREEN AVE UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60651-2419
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Country | US
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Telephone | 207-318-3279
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Fax |
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Provider Business Mailing Address
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Address Line | 3255 W EVERGREEN AVE UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60651-2419
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Country | US
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Telephone | 207-318-3279
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | BRITTANY MACLEOD
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Credential | PA-C
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Telephone | 207-318-3279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State | NULL
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