Provider Demographics
NPI:1043388630
Name:MCGUIRE, BIRGITTA T (MD)
Entity Type:Individual
Prefix:DR
First Name:BIRGITTA
Middle Name:T
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7447 W TALCOTT AVE
Mailing Address - Street 2:SUITE 409
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3745
Mailing Address - Country:US
Mailing Address - Phone:773-763-3808
Mailing Address - Fax:773-763-2885
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:SUITE 409
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-763-3808
Practice Address - Fax:773-763-2885
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036081319207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036081319Medicaid
ILE93401Medicare UPIN
IL036081319Medicaid