Provider Demographics
NPI:1710994512
Name:MCGRATH, PENNY S (MA)
Entity type:Individual
Prefix:MRS
First Name:PENNY
Middle Name:S
Last Name:MCGRATH
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 S STATE ST APT 15P
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2974
Mailing Address - Country:US
Mailing Address - Phone:312-612-9453
Mailing Address - Fax:
Practice Address - Street 1:111 W JACKSON BLVD FL 17
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-3589
Practice Address - Country:US
Practice Address - Phone:312-612-9453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005214101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional