Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 211000035 | IL |
NPI | 1124529847 |
---|---|
Provider Name | Julia Anne Mccay |
First Address | Oakbrook Terrace, IL 60181-3985 |
Second Address | Oak Park, IL 60304-1427 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2018 |
Last Update Date | 27/02/2018 |