MEDICARE: MCGUIRE MEDICAL SC

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	207V00000X	Obstetrics & Gynecology Physician		IL

General Provider Information

NPI Number	:	1588618094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCGUIRE MEDICAL SC

Provider Business Mailing Address
First Line	:	2315 E 93RD ST
Second Line	:	SUITE 224
City	:	CHICAGO
State	:	IL
Zip	:	60617-3910
Country	:	US
Telephone Number	:	773-731-6879
Fax Number	:	773-731-7791

Provider Business Practice Location Address
First Line	:	2315 E 93RD ST
Second Line	:	SUITE 224
City	:	CHICAGO
State	:	IL
Zip	:	60617-3910
Country	:	US
Telephone Number	:	773-731-6879
Fax Number	:	773-791-7791

Authorized Official
Title or Position	:	CEO
Name	:	RITA J MCGUIRE
Credential	:	MD
Telephone Number	:	773-731-6879

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	10/16/2007

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Directions to “MCGUIRE MEDICAL SC ” Practice Location

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