Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | IL |
NPI | 1639228554 |
---|---|
Provider Name | Dr. Laura A. Mcgrath |
First Address | Downers Grove, IL 60515-4520 |
Second Address | Downers Grove, IL 60515-4520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |