Individual provider Active NPI

Michael J. McGrail, M.D.

  • Adult Medicine Physician
  • Evergreen Park, IL
National Provider Identifier
1831341908
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
336082703 Issued in IL
Practice address
3860 W 95TH St
Suite 6
Evergreen Park, IL 60805-2034
Phone
(708) 425-3900
Fax
(708) 425-3939
NPI assigned
Oct 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 336082703 IL Primary

Addresses

Primary practice location

3860 W 95TH St
Suite 6
Evergreen Park, IL 60805-2034

Mailing address

3860 W 95TH St
Suite 6
Evergreen Park, IL 60805-2034
Phone (708) 425-3900

Other identifiers 1

IdentifierTypeStateIssuer
036-068995OtherILSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20090521000274 IL Practitioner - Geriatric MedicinePractitioner - General PracticePractitioner - Family Practice 8426107483 Practice locations: Oak Lawn, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
336082703ILMDAdult Medicine Physician

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
One Home Health LLCSchererville, IN, CCN 157662 Home health agency 5% Or Greater Direct Ownership Interest (12%)
Operational/Managerial Control
Jan 1, 2020
Mar 16, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1831341908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 W 95TH ST",
            "address_2": "SUITE 6",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052034",
            "telephone_number": "708-425-3900",
            "fax_number": "708-425-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 W 95TH ST",
            "address_2": "SUITE 6",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052034",
            "telephone_number": "708-425-3900",
            "fax_number": "708-425-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRAIL",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IL",
            "license": "336082703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036-068995",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.