PM Clinical Network

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

PM CLINICAL NETWORK

Practice address

720 S Wells St Apt 1615
Chicago, IL 60607-4793

Phone

(312) 623-1919

NPI assigned

Feb 14, 2022

Organization subpart

No

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

Authorized official

Name

Misha McCullough, MPH

Title

Ceo

Phone

(312) 623-1919

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1841945276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 S WELLS ST APT 1615",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074793",
            "telephone_number": "312-623-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S WELLS ST APT 1615",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074793",
            "telephone_number": "312-623-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PM CLINICAL NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "MISHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-623-1919",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kareo.com",
            "affiliation": "N",
            "address_1": "720 S Wells St Apt 1615",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606074793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Public Health or Welfare Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Public Health or Welfare Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.