Individual
MAGGIE LYNN MCNULTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 942-5000
Mailing address
600 S PAULINA ST STE 527, CHICAGO, IL 60612-3806
(312) 942-5495
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.054476
IL
2084N0400X
Neurology Physician
Primary
036130207
IL
2084N0600X
Clinical Neurophysiology Physician
036130207
IL
Other
Enumeration date
08/01/2008
Last updated
03/24/2022
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