Individual
MRS. RITA RAE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCTMB
Contact information
Practice address
1244 AMERICAN WAY, LIBERTYVILLE, IL 60048-3936
(847) 549-9595
(847) 549-9596
Mailing address
1244 AMERICAN WAY, LIBERTYVILLE, IL 60048-3936
(847) 549-9595
(847) 549-9596
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
227008684
IL
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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