Organization
MCMAHAN-CLEMIS INSTITUTE OF OTOLARYNGOLOGY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NYLANI S ALICEA (PRACTICE SUPERVISOR)
(312) 266-6673
Entity
Organization
Contact information
Practice address
151 N MICHIGAN AVE, STE 913, CHICAGO, IL 60601-7538
(312) 266-6673
(312) 266-3680
Mailing address
151 N MICHIGAN AVE, STE 913, CHICAGO, IL 60601-7506
(312) 266-6673
(312) 266-3680
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214532
MEDICARE PTAN
IL
Enumeration date
10/06/2006
Last updated
09/10/2014
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