Individual
DR. PATRICIA ANNE MCKENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
645 N MICHIGAN AVE STE 500, CHICAGO, IL 60611-2881
(312) 787-6173
Mailing address
645 N MICHIGAN AVE STE 500, CHICAGO, IL 60611-2881
(312) 787-6173
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071006109
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071006109
IL REG.
IL
01
—
1626613
BCBS PIN
IL
Enumeration date
09/27/2006
Last updated
05/19/2020
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