Mcnelly, Frederick Wright

Mcnelly, Frederick Wright is an individual health care provider with primary practice located at 972 N Main St , Rockford IL 61103-9652. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Mcnelly, Frederick Wright can be contacted via phone (815) 963-5095.

Contact Information

Primary practice address
972 N Main St Rockford IL 61103-9652
Phone: (815) 963-5095
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X IL711770 Illinois

Profile Details

NPI number 1619922572
LBN Legal business name Mcnelly, Frederick Wright
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Jul 8th, 2007 - about 18 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 1619922572 NPPES
Other 22039 NATIONAL REGISTER
Other 202 NATIONAL REGISTER

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