Individual
PATRICK L MCGINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3235 VOLLMER RD, SUITE 120, FLOSSMOOR, IL 60422-2013
(708) 957-3454
(708) 957-3495
Mailing address
2614 W JEFFERSON ST, JOLIET, IL 60435-6433
(815) 725-1355
(815) 725-9857
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036053460
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053460
—
IL
01
—
205474002
MEDICARE INDIV ID# FOR GROUP 205474
IL
01
—
208256002
MEDICARE INDIV ID# FOR GROUP 208256
IL
01
—
336140002
MEDICARE INDIV ID# FOR GROUP 336140
IL
01
—
P00791994
MEDICARE RR
IL
01
—
P00791994 GRP-C31261
MEDICARE RR
IL
Enumeration date
01/24/2007
Last updated
01/20/2012
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