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General NPI Number Information
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NPI Number | 1922085505
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Entity Type | Individual
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Provider Name | MISTY L MCNEILL DPM
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Gender | Female
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 532 S YORK ST
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City | ELMHURST
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State | IL
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Zip | 60126-3952
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Country | US
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Telephone | 630-834-3668
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Fax | 630-834-4015
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Provider Business Mailing Address
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Address Line | 532 S YORK ST
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City | ELMHURST
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State | IL
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Zip | 60126-3952
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Country | US
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Telephone | 630-834-3668
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Fax | 630-834-4015
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 016005059
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License Number State | IL
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