MEDICARE: DR. LAURA A. MCGRATH D.C.

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	111NN1001X	Nutrition Chiropractor		IL

General Provider Information

NPI Number	:	1639228554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA A. MCGRATH D.C.

Provider Business Mailing Address
First Line	:	5220 CARPENTER ST
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-4520
Country	:	US
Telephone Number	:	630-493-4491
Fax Number	:	630-493-4492

Provider Business Practice Location Address
First Line	:	5220 CARPENTER ST
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-4520
Country	:	US
Telephone Number	:	630-493-4491
Fax Number	:	630-493-4492

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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