Individual
KIM MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 SUPERIOR ST, SUITE 101, MELROSE PARK, IL 60160-4138
(708) 406-3040
(708) 406-3059
Mailing address
1111 SUPERIOR ST, SUITE 101, MELROSE PARK, IL 60160-4138
(708) 406-3040
(708) 406-3059
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041321035
IL
363L00000X
Nurse Practitioner
Primary
209012750
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
377002092
IL
Other
Enumeration date
04/09/2015
Last updated
01/23/2026
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