Organization
GARY M MCCRAY MD SC
Active
Parent organization
GARY M MCCRAY MD SC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GARY M MCCRAY MD SC
Authorized official
GARY MYLES MCCRAY MD (OWNER)
(708) 783-5572
Entity
Organization
Contact information
Practice address
1530 ALIMA TER, LA GRANGE PARK, IL 60526-1331
(708) 783-5572
(708) 482-4093
Mailing address
1530 ALIMA TER, LA GRANGE PARK, IL 60526-1331
(708) 783-5572
(708) 482-4093
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036064789
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621773
BLUE SHEILD
IL
05
—
036064789
—
IL
01
—
1023025541
TYPE I NPI
IL
01
—
1255512976
TYPE II NPI
IL
Enumeration date
02/10/2009
Last updated
02/13/2009
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