Individual
MR. JAMES GLENN MCNALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
1089 COMFORTCOVE DR, MACHESNEY PARK, IL 61115-7417
(815) 631-1234
Mailing address
1089 COMFORTCOVE DR, MACHESNEY PARK, IL 61115-7417
(815) 631-1234
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041389880
IL
163W00000X
Registered Nurse
Primary
161248-30
WI
Other
Enumeration date
11/21/2011
Last updated
11/21/2011
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