Individual
DR. GRACE VICTORIA DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1079 SOUTH MYRTLE AVENUE, KANKAKEE, IL 60901-5457
(815) 932-8161
(815) 932-8161
Mailing address
1079 SOUTH MYRTLE AVENUE, KANKAKEE, IL 60901-5457
(815) 932-8161
(815) 932-8161
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004708
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004708
—
IL
Enumeration date
08/30/2006
Last updated
11/14/2012
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