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General NPI Number Information
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NPI Number | 1013575182
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Entity Type | Individual
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Provider Name | MICHAEL JOHN MCGINNIS MD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 890 GARFIELD AVE STE 103
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-3100
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Country | US
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Telephone | 847-990-5670
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Fax | 847-279-0069
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone | 847-390-5900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 125.074121
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 73428
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 73428
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 036.170125
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 036.170125
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License Number State | IL
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