MEDICARE: DR. KEVIN J MCGARRY DC

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	111N00000X	Chiropractor	038.013501	IL

General Provider Information

NPI Number	:	1922648211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN J MCGARRY DC

Provider Business Mailing Address
First Line	:	113 PORTSMOUTH CT
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-3762
Country	:	US
Telephone Number	:	630-559-6127
Fax Number	:

Provider Business Practice Location Address
First Line	:	113 PORTSMOUTH CT
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-3762
Country	:	US
Telephone Number	:	630-559-6127
Fax Number	:

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

Provider Enumeration Date	:	01/14/2020
Last Update Date	:	01/14/2020

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