MEDICARE: JAMES M MC LAUGHLIN RN

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	163WM0705X	Medical-Surgical Registered Nurse	041300442	IL

General Provider Information

NPI Number	:	1093953457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES M MC LAUGHLIN RN

Provider Business Mailing Address
First Line	:	1604 VISA DR STE 1
Second Line	:
City	:	NORMAL
State	:	IL
Zip	:	61761-2195
Country	:	US
Telephone Number	:	309-846-4716
Fax Number	:	309-454-1107

Provider Business Practice Location Address
First Line	:	1604 VISA DR STE 1
Second Line	:
City	:	NORMAL
State	:	IL
Zip	:	61761-2195
Country	:	US
Telephone Number	:	309-846-4716
Fax Number	:	309-454-1107

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

Provider Enumeration Date	:	01/23/2009
Last Update Date	:	06/07/2026

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