Provider Demographics
NPI:1740260637
Name:MCADOO, JAMES S (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:MCADOO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:6785 WEAVER RD
Mailing Address - Street 2:STE D
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-8055
Mailing Address - Country:US
Mailing Address - Phone:815-397-3373
Mailing Address - Fax:815-516-0666
Practice Address - Street 1:3065 N PERRYVILLE RD
Practice Address - Street 2:STE 121
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-8053
Practice Address - Country:US
Practice Address - Phone:815-397-3373
Practice Address - Fax:815-516-0666
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2014-01-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036111771208200000X
FLOS 11955208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036111771Medicaid