Individual
MICHAEL J MCGRAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
245 S GARY AVE, SUITE 100, BLOOMINGDALE, IL 60108-2200
(630) 924-4009
(630) 924-9671
Mailing address
245 S GARY AVE, SUITE 100, BLOOMINGDALE, IL 60108-2200
(630) 924-4009
(630) 924-9671
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036091116
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222075
BLUE CROSS GROUP NUMBER
IL
05
—
036091116
—
IL
01
—
363149833
TAX IDENTIFICATION NUMBER
IL
01
—
3631498336019001
CDPG HFS PAYEE ID
IL
Enumeration date
07/11/2006
Last updated
04/12/2013
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