MEDICARE: MRS. PAMELA J MCCAMBRIDGE LMFT

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	106H00000X	Marriage & Family Therapist	166.000744	IL

General Provider Information

NPI Number	:	1467699173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAMELA J MCCAMBRIDGE LMFT

Provider Business Mailing Address
First Line	:	1336 ASHLAND AVE
Second Line	:
City	:	WILMETTE
State	:	IL
Zip	:	60091-1608
Country	:	US
Telephone Number	:	847-471-1256
Fax Number	:	847-342-0378

Provider Business Practice Location Address
First Line	:	3800 N WILKE RD
Second Line	:	SUITE 160
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-1278
Country	:	US
Telephone Number	:	847-471-1256
Fax Number	:

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

Provider Enumeration Date	:	01/16/2009
Last Update Date	:	03/03/2009

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