IndividualActive
Marketta Mccollough
NPI 1407517121 · Community Health Registered Nurse · Chicago, IL
Provider details
- NPI number
- 1407517121
- Entity type
- Individual
- Primary specialty
- Community Health Registered NurseNursing Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 2023-N1952 (IL)
Specialties & taxonomies
Nursing Service Providers
Nursing Service Providers
- Community Health Worker172V00000X
Other Service Providers
Nursing Service Providers
Nursing Service Providers
Practice location
9932 S Western Ave
Chicago, IL 60643-1831
Phone: (312) 868-0004
Approximate (ZIP-level) locationGet directions
Mailing address
500 Park Ave Apt 627
Calumet City, IL 60409-5034
Registry dates
- Enumerated
- 2022-01-05
- Last updated
- 2023-06-30
- Certified
- 2023-06-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.