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NPI Code Detail

MEDICARE: JANE E. MACGREEVY

MEDICARE: JANE E. MACGREEVY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker004310MO
21041C0700XClinical Social WorkerIL

General Provider Information

NPI Number : 1275749921
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE E. MACGREEVY
Provider Business Mailing Address
First Line : 2650 OLIVE ST
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63103-1424
Country : US
Telephone Number : 314-371-6500
Fax Number :
Provider Business Practice Location Address
First Line : 141 MARKET PL
Second Line : SUITE 206
City : FAIRVIEW HEIGHTS
State : IL
Zip : 62208-2034
Country : US
Telephone Number : 618-398-7250
Fax Number : 618-398-6870
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2007
Last Update Date : 07/08/2007

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