Healthcare Provider Details

I. General information

NPI: 1851725485
Provider Name (Legal Business Name): CAROL A MCGUIRE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2013
Last Update Date: 08/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 OGDEN AVE
AURORA IL
60504-7597
US

IV. Provider business mailing address

2111 OGDEN AVE
AURORA IL
60504-7597
US

V. Phone/Fax

Practice location:
  • Phone: 630-987-8380
  • Fax: 630-862-3085
Mailing address:
  • Phone: 630-987-8380
  • Fax: 630-862-3085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0800X
TaxonomyOrthopedic Registered Nurse
License Number041287189
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: