Provider Demographics
NPI:1255487229
Name:MCGUIRE, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:MCGUIRE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1425 W LINCOLN HWY
Mailing Address - Street 2:NORTHERN ILLINOIS UNIVERSITY HEALTH SERVICES
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-2828
Mailing Address - Country:US
Mailing Address - Phone:815-753-1311
Mailing Address - Fax:815-753-9599
Practice Address - Street 1:1425 W LINCOLN HWY
Practice Address - Street 2:NORTHERN ILLINOIS UNIVERSITY HEALTH SERVICES
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2828
Practice Address - Country:US
Practice Address - Phone:815-753-1311
Practice Address - Fax:815-753-9599
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2021-06-24
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Provider Licenses
StateLicense IDTaxonomies
IL036081372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1255487229Medicare UPIN
IL211332Medicare PIN