Marketta McCollough

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

2023-N1952 Issued in IL

Practice address

9932 S Western Ave
Chicago, IL 60643-1831

Phone

(312) 868-0004

NPI assigned

Jan 5, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Humility Health Care Services LLC

  • Homemaker
  • Chicago, IL
  • NPI 1477231231
  NPD Authorized official

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1407517121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PARK AVE APT 627",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095034",
            "telephone_number": "773-656-7427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9932 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431831",
            "telephone_number": "312-868-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLOUGH",
        "first_name": "MARKETTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "IL",
            "license": "2023-N1952",
            "primary": true
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "IL",
            "license": "2023-N1952",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "IL",
            "license": "2023-N1952",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "2023-N1952",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark McClurkin, M.D.
• James Marlin McCluskey III, MD
• McClymonds Psychological Services
• James McClymonds, PSY.D., HSPP
• Joan D McCohnell, PHD, LCSW
• Jason McCollum, MD
• Erin McComb, MD
• Meghan McComb, PHARM.D.
• Heather McCombs, DPM
• James Alan McCombs, DO

• Community Health Registered Nurse in Chicago, IL
• Providers in Chicago, IL by specialty
• Community Health Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.