Mcgrory, Mikaela Lynne

Mcgrory, Mikaela Lynne is an individual health care provider with primary practice located at 8200 W. Roosevelt Road , Forest Park IL 60130-2528. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mcgrory, Mikaela Lynne can be contacted via phone (708) 488-9850.

Contact Information

Primary practice address
8200 W. Roosevelt Road Forest Park IL 60130-2528
Phone: (708) 488-9850
Fax: (708) 488-9870
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085004288 Illinois

Profile Details

NPI number 1851666226
LBN Legal business name Mcgrory, Mikaela Lynne
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 18th, 2012
Last updated Oct 29th, 2015 - about 9 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 1851666226 NPPES
Illinois Other 085004288 LICENSE NO

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