Provider Demographics
NPI:1518212323
Name:MCHALE, MARY NOREEN (APN PMHNP-BC AOCN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:NOREEN
Last Name:MCHALE
Suffix:
Gender:F
Credentials:APN PMHNP-BC AOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W BERWYN AVE
Mailing Address - Street 2:UNIT 203
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-1199
Mailing Address - Country:US
Mailing Address - Phone:773-620-7624
Mailing Address - Fax:
Practice Address - Street 1:2000 W BERWYN AVE
Practice Address - Street 2:UNIT 203
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-1199
Practice Address - Country:US
Practice Address - Phone:773-620-7624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041170279163W00000X
IL209009540163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse