Provider Demographics
NPI:1528080157
Name:MCCARTNEY, DAVID (PT MS ATCL)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MCCARTNEY
Suffix:
Gender:M
Credentials:PT MS ATCL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9121 W 159TH ST
Mailing Address - Street 2:SUITE DRE
Mailing Address - City:ORLAND HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60487
Mailing Address - Country:US
Mailing Address - Phone:312-437-3305
Mailing Address - Fax:708-403-1177
Practice Address - Street 1:9121 W 159TH ST
Practice Address - Street 2:SUITE DRE
Practice Address - City:ORLAND HILLS
Practice Address - State:IL
Practice Address - Zip Code:60487
Practice Address - Country:US
Practice Address - Phone:708-403-1155
Practice Address - Fax:708-403-1177
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070013233225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL96514Medicare PIN