Organization
GARY M MCCRAY MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY MYLES MCCRAY M.D. (OWNER)
(708) 783-5572
Entity
Organization
Contact information
Practice address
1530 ALIMA TERRACE, LAGRANGE PARK, IL 60526-1331
(708) 783-5572
(708) 482-4093
Mailing address
1530 ALIMA TERRACE, LAGRANGE PARK, IL 60526-1331
(708) 783-5572
(708) 482-4093
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036-064789
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039-064789
—
IL
Enumeration date
11/21/2007
Last updated
10/14/2008
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