Provider Demographics
NPI:1235799644
Name:MULCAHY, HELEN ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:ELIZABETH
Last Name:MULCAHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:3232 LAKE AVE STE 330
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-1085
Practice Address - Country:US
Practice Address - Phone:224-226-9420
Practice Address - Fax:847-256-2140
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351045107208000000X
IL036.171459208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4351045107OtherLIMITED EDUCATION LICENSE
MI56315207212OtherCONTROLLED SUBSTANCE LICENSE