Mccammack, Edwin W.

Mccammack, Edwin W. is an individual health care provider with primary practice located at 101 W University Ave , Champaign IL 61820-3909. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Mccammack, Edwin W. can be contacted via phone (217) 366-1243.

Contact Information

Primary practice address
101 W University Ave Champaign IL 61820-3909
Phone: (217) 366-1243
Fax: (217) 366-6106
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 085-000055 Illinois

Profile Details

NPI number 1790792562
LBN Legal business name Mccammack, Edwin W.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2006
Last updated Mar 5th, 2015 - about 9 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 1790792562 NPPES
Other P00328875 RAILROAD MEDICARE
Other 434110 RAILROAD MEDICARE

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