Mcclellan, Kevin R

Mcclellan, Kevin R is an individual health care provider with primary practice located at 7421 N Milwaukee Ave , Niles IL 60714-3707. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mcclellan, Kevin R can be contacted via phone (773) 775-0811.

Contact Information

Primary practice address
7421 N Milwaukee Ave Niles IL 60714-3707
Phone: (773) 775-0811
Fax: (773) 819-7013
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036061120 Illinois

Profile Details

NPI number 1699835249
LBN Legal business name Mcclellan, Kevin R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Apr 24th, 2023 - about 3 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 1699835249 NPPES
Illinois Other 16202167 BCBS NUMBER
Illinois MEDICAID 036061120 BCBS NUMBER

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