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Individual

LINDA L GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
131 EAST JACKSON STREET, WALNUT, IL 61376
(815) 379-2161
Mailing address
101 E MILLER RD, STERLING, IL 61081-1252
(815) 625-4790

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-000187
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00278896
RAILROAD MEDICARE
IL
Enumeration date
05/12/2006
Last updated
08/10/2012
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