MEDICARE: DR. SCOTT RYAN GERAGHTY MD

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	2084N0400X	Neurology Physician	0101241338	VA
2	2085N0700X	Neuroradiology Physician	036131902	IL
3	2085R0202X	Diagnostic Radiology Physician	036131902	IL
4	2084N0400X	Neurology Physician	036131902	IL

General Provider Information

NPI Number	:	1871715995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT RYAN GERAGHTY MD

Provider Business Mailing Address
First Line	:	800 BIESTERFIELD RD STE 610
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3362
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 BIESTERFIELD RD STE 610
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3362
Country	:	US
Telephone Number	:	847-981-3630
Fax Number	:

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	01/17/2024

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