Individual provider Active NPI

Jeffrey M McMahon, ADN

  • Registered Nurse
  • Evergreen Park, IL
National Provider Identifier
1255779526
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041.362432 Issued in IL
Practice address
10223 S Sawyer Ave
Evergreen Park, IL 60805-3757
Phone
(708) 925-2802
NPI assigned
Jun 10, 2013
Last updated
Jun 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.362432 IL Primary

Addresses

Primary practice location

10223 S Sawyer Ave
Evergreen Park, IL 60805-3757

Mailing address

10223 S Sawyer Ave
Evergreen Park, IL 60805-3757
Phone (708) 925-2802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041.362432ILMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1255779526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10223 S SAWYER AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053757",
            "telephone_number": "708-925-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10223 S SAWYER AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053757",
            "telephone_number": "708-925-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "ADN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.362432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.