MEDICARE: DR. MICHAEL M MAGHRABI DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist		IL

General Provider Information

NPI Number	:	1598752651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL M MAGHRABI DPM

Provider Business Mailing Address
First Line	:	2623 S LAWNDALE AVE STE C
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4520
Country	:	US
Telephone Number	:	773-522-9700
Fax Number	:	773-522-9712

Provider Business Practice Location Address
First Line	:	2623 S LAWNDALE AVE
Second Line	:	STE C
City	:	CHICAGO
State	:	IL
Zip	:	60623-4520
Country	:	US
Telephone Number	:	773-522-9700
Fax Number	:	773-522-9712

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	03/18/2008

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