Provider Demographics
NPI:1518164615
Name:CATHERINE MCAULEY HEALTH SERVICES
Entity Type:Organization
Organization Name:CATHERINE MCAULEY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-975-4101
Mailing Address - Street 1:2691 RELIABLE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60686-0026
Mailing Address - Country:US
Mailing Address - Phone:734-975-4101
Mailing Address - Fax:734-975-4141
Practice Address - Street 1:1600 S CANTON CENTER RD
Practice Address - Street 2:SUITE 220
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-1992
Practice Address - Country:US
Practice Address - Phone:734-398-8790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty