Provider Demographics
NPI:1255771861
Name:MCINTOSH, ERIK (RN, ACNP-BC)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:MCINTOSH
Suffix:
Gender:M
Credentials:RN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N LA SALLE DR
Mailing Address - Street 2:UNIT 3506
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-8539
Mailing Address - Country:US
Mailing Address - Phone:773-316-5551
Mailing Address - Fax:
Practice Address - Street 1:1650 W HARRISON ST
Practice Address - Street 2:SUITE 706 NORTH ATRIUM
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3800
Practice Address - Country:US
Practice Address - Phone:312-942-5025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.010447363L00000X
IL209010447363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care