Provider Demographics
NPI:1679540595
Name:MCNALLY, JOSEPH P (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:P
Last Name:MCNALLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2401 HARNISH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-6846
Mailing Address - Country:US
Mailing Address - Phone:847-440-2281
Mailing Address - Fax:224-241-8394
Practice Address - Street 1:2401 HARNISH DR STE 100
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-6846
Practice Address - Country:US
Practice Address - Phone:847-440-2281
Practice Address - Fax:224-241-8394
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0360887422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036088742Medicaid
F63504Medicare UPIN