Provider Demographics
NPI:1174616403
Name:MCCARTHY, MEGGAN P (RN PA-C)
Entity type:Individual
Prefix:MISS
First Name:MEGGAN
Middle Name:P
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:RN PA-C
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Mailing Address - Street 1:251 E HURON ST
Mailing Address - Street 2:SUITE 11-140
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2908
Mailing Address - Country:US
Mailing Address - Phone:312-926-1711
Mailing Address - Fax:
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:SUITE 11/140
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-926-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2015-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601004862363AS0400X
IL085003017363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical