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NPI Code Detail

MEDICARE: MICHAEL MCNETT MD SC

MEDICARE: MICHAEL MCNETT MD SC
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
1208VP0000XPain Medicine PhysicianIL

General Provider Information

NPI Number : 1487855219
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHAEL MCNETT MD SC
Provider Business Mailing Address
First Line : 4332 N ELSTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2144
Country : US
Telephone Number : 773-604-5321
Fax Number : 773-604-5231
Provider Business Practice Location Address
First Line : 4332 N ELSTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2144
Country : US
Telephone Number : 773-604-5321
Fax Number : 773-604-5231
Authorized Official
Title or Position : MEDICAL DOCTOR
Name : DR. MICHAEL MCNETT
Credential : M.D.
Telephone Number : 773-604-5321
Provider Enumeration Date : 05/30/2007
Last Update Date : 02/14/2008

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