Provider Demographics
NPI:1497765168
Name:MCDEVITT, JUDITH H (PHD, NP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:H
Last Name:MCDEVITT
Suffix:
Gender:F
Credentials:PHD, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 S. DAMEN AVE.
Mailing Address - Street 2:UIC COLLEGE OF NURSING (MC802) SUITE 912
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-7350
Mailing Address - Country:US
Mailing Address - Phone:312-996-9175
Mailing Address - Fax:312-996-7725
Practice Address - Street 1:734 W. 47TH STREET
Practice Address - Street 2:IHC SOUTH
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609
Practice Address - Country:US
Practice Address - Phone:312-536-8400
Practice Address - Fax:773-536-2406
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL544480Medicare ID - Type Unspecified
ILT24117Medicare UPIN