Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 071006273 | IL |
N | 103TC0700X | Clinical Psychologist | 071006273 | IL |
Y | 103G00000X | Clinical Psychologist | 071006273 | IL |
Y | 103TC0700X | Clinical Psychologist | 071006273 | IL |
N | 103TR0400X | Rehabilitation Psychologist | 071006273 | IL |
NPI | 1477723963 |
---|---|
Provider Name | Dr. Mary Ann Mcmorrow |
First Address | Chicago, IL 60611-2654 |
Second Address | Chicago, IL 60611-2654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2008 |
Last Update Date | 11/03/2008 |