Organization
MAUREEN MCSHANE DPM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAUREEN T MCSHANE DPM (OWNER)
(773) 233-0990
Entity
Organization
Contact information
Practice address
11238 S WESTERN AVE, CHICAGO, IL 60643-4116
(773) 233-0990
(773) 233-0992
Mailing address
11238 S WESTERN AVE, CHICAGO, IL 60643-4116
(773) 233-0990
(773) 233-0992
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004635
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001605234
BC/BS OF ILLINOIS
IL
Enumeration date
02/17/2009
Last updated
08/17/2015
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