MEDICARE: MCEWAN & ASSOCIATES, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	277.000077	OTHER	IL	STATE LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033651724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCEWAN & ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	2435 N SHEFFIELD AVE
Second Line	:	STE 9
City	:	CHICAGO
State	:	IL
Zip	:	60614-2277
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 E OHIO STREET
Second Line	:	STE 410 #2191
City	:	CHICAGO
State	:	IL
Zip	:	60611-5288
Country	:	US
Telephone Number	:	773-809-1531
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICK DANIEL MCEWAN
Credential	:	APRN-FPA
Telephone Number	:	773-809-1531

Provider Enumeration Date	:	11/10/2016
Last Update Date	:	10/02/2024

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