Individual provider · Type 1 NPI
Marketta McCollough
Community Health Registered Nurse · Chicago, IL
NPI number
1407517121
Active
Practice location
9932 S Western Ave
Chicago, IL 60643-1831
Mailing address
500 Park Ave Apt 627
Calumet City, IL 60409-5034
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community Health Registered Nurse Primary | 163WC1500X | 2023-N1952 (IL) |
| Rehabilitation Registered Nurse | 163WR0400X | 2023-N1952 (IL) |
| Community Health Worker | 172V00000X | None listed |
| Home Health Registered Nurse | 163WH0200X | 2023-N1952 (IL) |
| Registered Nurse | 163W00000X | 2023-N1952 (IL) |
Community Health Registered Nurse: Definition to come...
Another provider at this address
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About NPI 1407517121
Marketta McCollough's National Provider Identifier is 1407517121, issued on Jan 5, 2022. The primary taxonomy on file is Community Health Registered Nurse (163WC1500X), and the practice location is in Chicago, IL. The record was last updated on Jun 30, 2023.