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NPI Code Detail

MEDICARE: JAMES P CLANCY MD

MEDICARE:   JAMES P CLANCY  MD
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
1207Q00000XFamily Medicine Physician036096295IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538162102
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES P CLANCY MD
Provider Business Mailing Address
First Line : 2306 W. TOUHY AVENUE
Second Line :
City : CHICAGO
State : IL
Zip : 60645
Country : US
Telephone Number : 773-262-7000
Fax Number : 773-262-7002
Provider Business Practice Location Address
First Line : 2306 W. TOUHY AVENUE
Second Line :
City : CHICAGO
State : IL
Zip : 60645
Country : US
Telephone Number : 773-262-7000
Fax Number : 773-262-7002
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 07/08/2007

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Directions to “ JAMES P CLANCY MD” Practice Location

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