Individual
MAUREEN A MCCAFFERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APN
Contact information
Practice address
4950 W 95TH ST, OAK LAWN, IL 60453-2504
(708) 576-8150
(708) 576-8831
Mailing address
4950 W 95TH ST, OAK LAWN, IL 60453-2504
(708) 576-8150
(708) 576-8831
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-204506
IL
364S00000X
Clinical Nurse Specialist
Primary
209-004103
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041204506
—
IL
01
—
21622931
BCBS GROUP #
IL
01
—
526200
MEDICARE GROUP #
IL
01
—
CI8250
PALMETTO GBA GROUP #
IL
01
—
P00051231
PALMETTO GBA INDIVIDUAL #
IL
Enumeration date
08/26/2005
Last updated
12/31/2021
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