MEDICARE: GAIL MACLEAN MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	AY780	FL

General Provider Information

NPI Number	:	1346412806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL MACLEAN MS

Provider Business Mailing Address
First Line	:	215 SHUMAN BLVD
Second Line	:	SUITE 401
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-8458
Country	:	US
Telephone Number	:	630-303-5380
Fax Number	:	978-313-6824

Provider Business Practice Location Address
First Line	:	2232 NE 123RD ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2904
Country	:	US
Telephone Number	:	786-342-7151
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2008
Last Update Date	:	04/06/2015

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