Eileen Therese McDermott, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209-003052 Issued in IL

Practice address

30 E 15TH St
Suite 207
Chicago Heights, IL 60411

Phone

(708) 756-5454

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336953600000",
    "number": "1407816440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10947 S DRAKE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60655",
            "telephone_number": "773-259-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 15TH ST",
            "address_2": "SUITE 207",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "60411",
            "telephone_number": "708-756-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "EILEEN",
        "middle_name": "THERESE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2012-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209-003052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camisha Martin
• Victoria Mason
• Haley M Masters, MD
• Tenisha Shawan McCaskill, M.D
• Matthew McCormick
• McGowan Family Health & Wellness Center P.C.
• Sandra Renee McGowan, M.D.
• Dr. Aaron McKenzie, MSW, PH.D
• Michael McKinney
• Paulette McKinnis

• Gerontology Nurse Practitioner in Chicago Heights, IL
• Providers in Chicago Heights, IL by specialty
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; 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.