Provider Demographics
NPI:1245864818
Name:MCGRATH, HANNAH MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2973 N ELSTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-7907
Mailing Address - Country:US
Mailing Address - Phone:708-669-9976
Mailing Address - Fax:
Practice Address - Street 1:PSC 817 BOX 481
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09622-0005
Practice Address - Country:US
Practice Address - Phone:708-699-9976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-23
Last Update Date:2020-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.006563363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant