Provider Demographics
NPI:1740401371
Name:MCCANN, MARGARET EILEEN (OTRL)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:EILEEN
Last Name:MCCANN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16512 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5371
Mailing Address - Country:US
Mailing Address - Phone:312-961-1629
Mailing Address - Fax:
Practice Address - Street 1:EAST 65TH STREET AT LAKE MICHIGAN
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649
Practice Address - Country:US
Practice Address - Phone:773-363-6700
Practice Address - Fax:773-363-3481
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL56005976225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist