Provider Demographics
NPI:1538471867
Name:MCPHERSON, AMY M (DPM)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:M
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 PEMBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-7730
Mailing Address - Country:US
Mailing Address - Phone:815-600-0448
Mailing Address - Fax:
Practice Address - Street 1:1614 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-4302
Practice Address - Country:US
Practice Address - Phone:708-452-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016.005413213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery