Healthcare Provider Details

I. General information

NPI: 1649577099
Provider Name (Legal Business Name): MS. DONNA MCGRATH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2011
Last Update Date: 02/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N HIGHLAND AVE.
AURORA IL
60506-3814
US

IV. Provider business mailing address

99 E KENDALL DR
YORKVILLE IL
60560-1030
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-2532
  • Fax:
Mailing address:
  • Phone: 630-913-1053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.010635
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: