Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 016003845 | IL |
NPI | 1033287024 |
---|---|
Provider Name | Dr. Kathryn S Grace |
First Address | Glenview, IL 60026-8000 |
Second Address | Glenview, IL 60026-8000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 28/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00208698 | RAILROAD MEDICARE (01) | IL |
T38774 | (02) | IL |