Individual
JUSTIN MICHAEL DAGRACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 N LASALLE ST APT 3610, CHICAGO, IL 60654-8535
(585) 314-7806
Mailing address
400 N LASALLE ST APT 3610, CHICAGO, IL 60654-8535
(585) 314-7806
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
125055630
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2008
Last updated
07/16/2010
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