MARKETTA MCCOLLOUGH NPI 1407517121

NPI Information

NPI: 1407517121
Provider Name: MARKETTA MCCOLLOUGH
Classification: Registered Nurse - 163WC1500X
Entity Type: Individual

Specialization: Community Health

Address:
9932 S WESTERN AVE
CHICAGO, IL
ZIP 60643
Phone: (312) 868-0004
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Marketta Mccollough is a community health registered nurse in Chicago, IL. Marketta Mccollough NPI is 1407517121. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9932 S WESTERN AVE
CHICAGO, IL
ZIP 60643-831
Phone: (312) 868-0004

The enumeration date for this NPI number is 1/5/2022 and was last updated on 6/30/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WC1500X	Registered Nurse	Community Health	2023-N1952	ILLINOIS	Yes
2	163WR0400X	Registered Nurse	Rehabilitation	2023-N1952	ILLINOIS	No
3	172V00000X	Community Health Worker				No
4	163WH0200X	Registered Nurse	Home Health	2023-N1952	ILLINOIS	No
5	163W00000X	Registered Nurse		2023-N1952	ILLINOIS	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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