Provider Demographics
NPI:1528083987
Name:MCGUINN, MARCELLA LYNN (MD)
Entity type:Individual
Prefix:
First Name:MARCELLA
Middle Name:LYNN
Last Name:MCGUINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1260 W WASHINGTON BLVD
Mailing Address - Street 2:APT 702
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-1962
Mailing Address - Country:US
Mailing Address - Phone:312-733-0971
Mailing Address - Fax:
Practice Address - Street 1:610 S MAPLE AVE STE 4050
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1091
Practice Address - Country:US
Practice Address - Phone:888-220-6432
Practice Address - Fax:708-613-4382
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100912207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILI120297Medicare UPIN