MEDICARE: DR. HILARY STRAWN MCELLIGOTT M.D.

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
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	036.119168	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	036.119168	OTHER	IL	036.119168

General Provider Information

NPI Number	:	1467600429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HILARY STRAWN MCELLIGOTT M.D.

Provider Business Mailing Address
First Line	:	7307 FRANKLIN ST
Second Line	:
City	:	FOREST PARK
State	:	IL
Zip	:	60130-1104
Country	:	US
Telephone Number	:	708-689-8150
Fax Number	:

Provider Business Practice Location Address
First Line	:	7307 FRANKLIN ST
Second Line	:
City	:	FOREST PARK
State	:	IL
Zip	:	60130-1104
Country	:	US
Telephone Number	:	708-689-8150
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	09/03/2008

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