MEDICARE: JOSEPHINE N. MCCASKILL

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	261QH0100X	Health Service Clinic/Center	209004940	IL
2	261Q00000X	Clinic/Center	209004940	IL

General Provider Information

NPI Number	:	1194718742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPHINE N. MCCASKILL

Provider Business Mailing Address
First Line	:	3153 E BENDING CREEK TRL
Second Line	:	PO BOX 545
City	:	CRETE
State	:	IL
Zip	:	60417-3861
Country	:	US
Telephone Number	:	773-640-7944
Fax Number	:

Provider Business Practice Location Address
First Line	:	3153 E BENDING CREEK TRL
Second Line	:
City	:	CRETE
State	:	IL
Zip	:	60417-3861
Country	:	US
Telephone Number	:	773-640-7944
Fax Number	:

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	JOSEPHINE MCCASKILL
Credential	:	NP
Telephone Number	:	773-640-7944

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	10/23/2009

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