Provider Demographics
NPI:1366189250
Name:MCCORMICK, ERICK MITCHELL (RN)
Entity type:Individual
Prefix:MR
First Name:ERICK
Middle Name:MITCHELL
Last Name:MCCORMICK
Suffix:
Gender:M
Credentials:RN
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Mailing Address - Street 1:10141 W YORK HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BEACH PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60087-2405
Mailing Address - Country:US
Mailing Address - Phone:224-723-7112
Mailing Address - Fax:
Practice Address - Street 1:3333 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-3037
Practice Address - Country:US
Practice Address - Phone:847-578-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.453025163W00000X
IL041453025367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse