Provider Demographics
NPI:1770679359
Name:MCCAHILL, MICHAEL JOHN (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:MCCAHILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16345 HARLEM AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-2589
Mailing Address - Country:US
Mailing Address - Phone:708-429-5904
Mailing Address - Fax:708-429-0094
Practice Address - Street 1:16345 HARLEM AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-2589
Practice Address - Country:US
Practice Address - Phone:708-429-5904
Practice Address - Fax:708-429-0094
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007077111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU37254Medicare UPIN
IL212660Medicare ID - Type UnspecifiedMEDICARE ID