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General NPI Number Information
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NPI Number | 1710994512
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Entity Type | Individual
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Provider Name | PENNY S MCGRATH MA
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Gender | Female
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 111 W JACKSON BLVD FL 17
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City | CHICAGO
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State | IL
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Zip | 60604-3589
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Country | US
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Telephone | 312-612-9453
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Fax |
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Provider Business Mailing Address
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Address Line | 1530 S STATE ST APT 15P
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City | CHICAGO
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State | IL
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Zip | 60605-2974
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Country | US
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Telephone | 312-612-9453
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180005214
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License Number State | IL
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