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NPI Code Detail

MEDICARE: MRS. CHERYL L MCLEAN APN

MEDICARE: MRS. CHERYL L MCLEAN 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
1363L00000XNurse Practitioner209001861IL

General Provider Information

NPI Number : 1346314960
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHERYL L MCLEAN APN
Provider Business Mailing Address
First Line : 625 N MICHIGAN AVE
Second Line : SUITE 210
City : CHICAGO
State : IL
Zip : 60611-3110
Country : US
Telephone Number : 708-488-0072
Fax Number : 708-488-0084
Provider Business Practice Location Address
First Line : 625 N MICHIGAN AVE
Second Line : SUITE 210
City : CHICAGO
State : IL
Zip : 60611-3110
Country : US
Telephone Number : 708-488-0072
Fax Number : 708-488-0084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 06/26/2012

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