Healthcare Provider Details

I. General information

NPI: 1831002740
Provider Name (Legal Business Name): MATTHEW MCGRATH
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 S LINCOLNWAY STE 120
NORTH AURORA IL
60542-1659
US

IV. Provider business mailing address

161 S LINCOLNWAY STE 120
NORTH AURORA IL
60542-1659
US

V. Phone/Fax

Practice location:
  • Phone: 630-859-2504
  • Fax: 708-202-5443
Mailing address:
  • Phone: 630-859-2504
  • Fax: 708-202-5443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number043.107458
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: