Individual provider Active NPI

Phillip C. McKegg

  • Student in an Organized Health Care Education/Training Program
  • Downers Grove, IL
National Provider Identifier
1083491195
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
555 31St St
Downers Grove, IL 60515-1235
Phone
(800) 458-6253
NPI assigned
Sep 12, 2023
Last updated
Sep 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

555 31St St
Downers Grove, IL 60515-1235

Mailing address

555 31St St
Downers Grove, IL 60515-1235
Phone (800) 458-6253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250614000316 MI Order and Referring Only - AnesthesiologyPractitioner - Anesthesiology 8123539483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1083491195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 31ST ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151235",
            "telephone_number": "800-458-6253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 31ST ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151235",
            "telephone_number": "800-458-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEGG",
        "first_name": "PHILLIP",
        "middle_name": "C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.