MEDICARE: EILEEN MCCANN APN

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	209002711	IL

General Provider Information

NPI Number	:	1093041055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN MCCANN APN

Provider Business Mailing Address
First Line	:	10601 S KILDARE AVE
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-5303
Country	:	US
Telephone Number	:	708-229-2370
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 W 103RD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60655-3105
Country	:	US
Telephone Number	:	773-298-3712
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2009
Last Update Date	:	02/15/2017

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Directions to “ EILEEN MCCANN APN” Practice Location

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