Provider Demographics
NPI:1063037091
Name:MCCARTHY, ANDREW JON (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JON
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9650 GROSS POINT RD STE 2900
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-5006
Mailing Address - Country:US
Mailing Address - Phone:224-251-2987
Mailing Address - Fax:224-251-5086
Practice Address - Street 1:9650 GROSS POINT RD STE 2900
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-5006
Practice Address - Country:US
Practice Address - Phone:224-251-2987
Practice Address - Fax:224-251-5086
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085008918363A00000X
363AS0400X
IL085.008918363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant