Provider Demographics
NPI:1699898494
Name:MULCHRONE, NORA ANN
Entity type:Individual
Prefix:MS
First Name:NORA
Middle Name:ANN
Last Name:MULCHRONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 W 112TH ST
Mailing Address - Street 2:UNIT 9
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-1345
Mailing Address - Country:US
Mailing Address - Phone:773-213-0695
Mailing Address - Fax:
Practice Address - Street 1:2550 W 112TH ST
Practice Address - Street 2:UNIT 9
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-1345
Practice Address - Country:US
Practice Address - Phone:773-213-0695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILNM69690101P222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist