Provider Demographics
NPI:1326081480
Name:MCNELIS, MARGARET (OD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:MCNELIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4134
Mailing Address - Country:US
Mailing Address - Phone:847-621-0633
Mailing Address - Fax:847-621-0640
Practice Address - Street 1:2010 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 121
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4134
Practice Address - Country:US
Practice Address - Phone:847-621-0633
Practice Address - Fax:847-621-0640
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046008388152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U27380Medicare UPIN