Mcdermott, Michael J

Mcdermott, Michael J is an sole proprietor health care provider with primary practice located at 14532 John Humphrey Dr , Orland Park IL 60462-2640. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Mcdermott, Michael J can be contacted via phone (708) 403-1611.

Contact Information

Primary practice address
14532 John Humphrey Dr Orland Park IL 60462-2640
Phone: (708) 403-1611
Fax: (708) 403-1650
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016004034 Illinois

Profile Details

NPI number 1538119987
LBN Legal business name Mcdermott, Michael J
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 10th, 2006
Last updated Dec 15th, 2021 - about 5 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 1538119987 NPPES
Other 60101286 BLUE CROSS
Other 363863248 BLUE CROSS
Other 363863248 BLUE CROSS
Other IL4307 BLUE CROSS
MEDICAID 016004034 BLUE CROSS
Other 363863248 BLUE CROSS

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