Provider Demographics
NPI:1477536589
Name:MCCALL, LINDA L (CNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:L
Last Name:MCCALL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:S
Other - Last Name:MCCALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNP
Mailing Address - Street 1:2501 CHATHAM RD
Mailing Address - Street 2:STE 300
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704
Mailing Address - Country:US
Mailing Address - Phone:217-787-8870
Mailing Address - Fax:217-787-6158
Practice Address - Street 1:2501 CHATHAM RD
Practice Address - Street 2:STE 300
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704
Practice Address - Country:US
Practice Address - Phone:217-787-8870
Practice Address - Fax:217-787-6158
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209004577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041141945Medicaid
ILK31727Medicare PIN
ILP76759Medicare UPIN