Provider Demographics
NPI:1184705030
Name:MCANDREWS, MARY T (DC)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:T
Last Name:MCANDREWS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 N HICKS RD STE 110
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-3610
Mailing Address - Country:US
Mailing Address - Phone:224-544-5777
Mailing Address - Fax:224-544-5792
Practice Address - Street 1:660 N HICKS RD STE 110
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-3610
Practice Address - Country:US
Practice Address - Phone:224-544-5777
Practice Address - Fax:224-544-5792
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U83053Medicare UPIN
ILK23015Medicare PIN