Provider Demographics
NPI:1457780330
Name:MCNAIR, PAMELA
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:MCNAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:B M
Other - Middle Name:
Other - Last Name:TRANSPORTATION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:500 EAST 33RD STREET
Mailing Address - Street 2:UNIT 1115
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616
Mailing Address - Country:US
Mailing Address - Phone:773-459-0990
Mailing Address - Fax:
Practice Address - Street 1:14239 WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:DIXMOOR
Practice Address - State:IL
Practice Address - Zip Code:60426-1151
Practice Address - Country:US
Practice Address - Phone:773-459-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor