Mcclellan, John B

Mcclellan, John B is an individual health care provider with primary practice located at 5540 W 111Th St , Oak Lawn IL 60453-5574. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Mcclellan, John B can be contacted via phone (708) 423-8440.

Contact Information

Primary practice address
5540 W 111Th St Oak Lawn IL 60453-5574
Fax: (708) 658-2962
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 036055747 Illinois

Profile Details

NPI number 1710974472
LBN Legal business name Mcclellan, John B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2005
Last updated Mar 13th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710974472 NPPES
Illinois Other 01623030 BCBS
Illinois MEDICAID 036055747 BCBS
Illinois Other F400279788 BCBS

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