Provider Demographics
NPI:1568490282
Name:MCNAMARA, ANN P (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:P
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 W HURON ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-3431
Mailing Address - Country:US
Mailing Address - Phone:312-440-5150
Mailing Address - Fax:
Practice Address - Street 1:409 W HURON ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-3431
Practice Address - Country:US
Practice Address - Phone:312-440-5150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G78801Medicare UPIN