Ian V Mackey, M.S., P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-001699 Issued in IL

Practice address

9669 Kenton Ave Ste 209
Skokie, IL 60076-1226

Phone

(847) 679-8000

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 22, 2016 through Feb 22, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Collaborative Behavioral Health LLC

  • Clinical Psychologist
  • Skokie, IL
  • NPI 1194190520

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720109424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE STE 209",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE STE 209",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761226",
            "telephone_number": "847-679-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKEY",
        "first_name": "IAN",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "credential": "M.S., P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Jay Maarcus, D.D.S.
• Mary Rose Mabbagu, APN-CNP
• Elizabeth Macafee, MSW, LCSW
• Dennis T. Macas, ATC
• Terri Machtiger, MS ED
• Susan Mackey, PH.D.
• Amy Madhiwala, PHARM.D.
• Anna Lorna Y Madla, PT
• Emma Magee, LSW
• Cheryl Magence, O.T.

• Physician Assistant in Skokie, IL
• Providers in Skokie, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.