Provider Demographics
NPI:1639221062
Name:MCCUE, KANDACE MARIE (MA)
Entity Type:Individual
Prefix:MRS
First Name:KANDACE
Middle Name:MARIE
Last Name:MCCUE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6185 PINEWOOD CT
Mailing Address - Street 2:UNIT 102
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-3119
Mailing Address - Country:US
Mailing Address - Phone:630-455-9886
Mailing Address - Fax:
Practice Address - Street 1:5TH & ROOSEVELT ROAD
Practice Address - Street 2:
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141-5000
Practice Address - Country:US
Practice Address - Phone:708-202-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CX0006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorOrientation and Mobility Training Provider