Timothy K McGonagle, M.D,

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

036-083835 Issued in IL

Practice address

3340 Oak Park Ave
Suite 200
Berwyn, IL 60402-3420

Phone

(708) 783-0222

Fax

(708) 783-0223

NPI assigned

Sep 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1144215229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 OAK PARK AVE",
            "address_2": "SUITE 200",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023420",
            "telephone_number": "708-783-0222",
            "fax_number": "708-783-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 OAK PARK AVE",
            "address_2": "SUITE 200",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023420",
            "telephone_number": "708-783-0222",
            "fax_number": "708-783-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGONAGLE",
        "first_name": "TIMOTHY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036-083835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036083835",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "130024570",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chandra A Matteson, NP-C
• Fernanda Maytorena-Unger, LCSW
• Jessica McCormick
• Lawrence McDonald
• Jennifer M McFee, PHARMD, CDM
• McKenna Physical Therapy and Wellness PLLC
• Corinne T McKenna
• Alexandria Z Meccia, MD
• Medical Surgical Dermatology, SC
• Kathleen Patricia Medici, APN

• Neurology Physician in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.