Individual
MARKETTA MCCOLLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9932 S WESTERN AVE, CHICAGO, IL 60643-1831
(312) 868-0004
Mailing address
500 PARK AVE APT 627, CALUMET CITY, IL 60409-5034
(773) 656-7427
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2023-N1952
IL
163WC1500X
Community Health Registered Nurse
Primary
2023-N1952
IL
163WH0200X
Home Health Registered Nurse
2023-N1952
IL
163WR0400X
Rehabilitation Registered Nurse
2023-N1952
IL
172V00000X
Community Health Worker
—
—
Other
Enumeration date
01/05/2022
Last updated
06/30/2023
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