Healthcare Provider Details

I. General information

NPI: 1710945852
Provider Name (Legal Business Name): JAMES V MCGARRY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 09/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 W 203RD ST SUITE 301
OLYMPIA FIELDS IL
60461-1180
US

IV. Provider business mailing address

1040 SIERRA DR 400
GREENWOOD IN
46143-7241
US

V. Phone/Fax

Practice location:
  • Phone: 708-709-6295
  • Fax: 708-709-6353
Mailing address:
  • Phone: 317-865-8988
  • Fax: 317-859-8590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036059151
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: