Provider Demographics
NPI:1154035814
Name:MCABEE, AVA ROSEMARY
Entity type:Individual
Prefix:
First Name:AVA
Middle Name:ROSEMARY
Last Name:MCABEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAC
Other - Middle Name:ROSEMARY
Other - Last Name:MCABEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6666 GREEN VALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-7068
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 S HALSTED ST # 307B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3628
Practice Address - Country:US
Practice Address - Phone:612-413-9511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator