Healthcare Provider Details

I. General information

NPI: 1942203617
Provider Name (Legal Business Name): MURRAY D MCGRADY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 04/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 WOLF CREEK DR DEPT OTOLARYNGOLOGY
SWANSEA IL
62226-2355
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 618-235-3687
  • Fax: 618-239-9492
Mailing address:
  • Phone: 618-235-3687
  • Fax: 618-239-9492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number036076334
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: