Provider Demographics
NPI:1639228554
Name:MCGRATH, LAURA A (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:A
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 CARPENTER ST
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-4520
Mailing Address - Country:US
Mailing Address - Phone:630-493-4491
Mailing Address - Fax:630-493-4492
Practice Address - Street 1:5220 CARPENTER ST
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4520
Practice Address - Country:US
Practice Address - Phone:630-493-4491
Practice Address - Fax:630-493-4492
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition