MEDICARE: RICK MCEWAN

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	363L00000X	Nurse Practitioner	277.000077	IL
2	363LF0000X	Family Nurse Practitioner	277.000077	IL
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	277.000077	IL

General Provider Information

NPI Number	:	1558736736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICK MCEWAN

Provider Business Mailing Address
First Line	:	2435 N SHEFFIELD AVE STE 9
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-2277
Country	:	US
Telephone Number	:	773-809-1531
Fax Number	:	331-233-1303

Provider Business Practice Location Address
First Line	:	680 N LAKE SHORE DR STE 110
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4447
Country	:	US
Telephone Number	:	773-809-1531
Fax Number	:	331-233-1303

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

Provider Enumeration Date	:	12/14/2015
Last Update Date	:	06/18/2025

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Directions to “ RICK MCEWAN ” Practice Location

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