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NPI Code Detail

MEDICARE: PEARL CALLAGHAN

MEDICARE:   PEARL  CALLAGHAN
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
1363LF0000XFamily Nurse PractitionerIL

General Provider Information

NPI Number : 1831282086
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEARL CALLAGHAN
Provider Business Mailing Address
First Line : 161 WASHINGTON ST
Second Line : EIGHT TOWER BRIDGE, SUITE 1400
City : CONSHOHOCKEN
State : PA
Zip : 19428
Country : US
Telephone Number : 866-825-3227
Fax Number : 484-351-3800
Provider Business Practice Location Address
First Line : 1207 N RANDALL RD
Second Line :
City : AURORA
State : IL
Zip : 60506
Country : US
Telephone Number : 866-825-3227
Fax Number : 484-351-3800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/08/2007

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Directions to “ PEARL CALLAGHAN ” Practice Location

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