Mcgrady, Douglas J

Mcgrady, Douglas J is an individual health care provider with primary practice located at 5409 N Knoxville Ave , Peoria IL 61614-5069. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Mcgrady, Douglas J can be contacted via phone (309) 683-6151.

Contact Information

Primary practice address
5409 N Knoxville Ave Peoria IL 61614-5069
Phone: (309) 683-6151
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 036064415 Illinois

Profile Details

NPI number 1578501896
LBN Legal business name Mcgrady, Douglas J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Aug 13th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578501896 NPPES
Illinois Other 220009330 RAILROAD MEDICARE
Illinois MEDICAID 0360644151 RAILROAD MEDICARE

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