Provider Demographics
NPI:1598873622
Name:MCKAY, MAURA ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:MAURA
Middle Name:ANN
Last Name:MCKAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BLANCHARD CIR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-1037
Mailing Address - Country:US
Mailing Address - Phone:630-682-0500
Mailing Address - Fax:
Practice Address - Street 1:7 BLANCHARD CIR
Practice Address - Street 2:SUITE 102
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-1037
Practice Address - Country:US
Practice Address - Phone:630-682-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH97332Medicare UPIN