Organization
DRS GRAHAM & GRAHAM LTD
Active
Other names
Drs Graham & Graham LTD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRENCE M GRAHAM DPM, FACFAS (PRESIDENT)
(271) 875-3668
Entity
Organization
Contact information
Practice address
102 W KENWOOD AVE, SUITE 150, DECATUR, IL 62526-4368
(217) 875-3668
(217) 845-4277
Mailing address
102 W KENWOOD AVE, SUITE 150, DECATUR, IL 62526-4368
(217) 875-3668
(217) 845-4277
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016-003032
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC0187
RR GROUP
IL
Enumeration date
05/04/2007
Last updated
06/21/2018
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