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Individual

DR. SANDRA LUKIC GRABA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
525 E CONGRESS PKWY, CRYSTAL LAKE, IL 60014-6245
(815) 459-6780
(815) 459-1648
Mailing address
2215 SANDERS RD STE 105, NORTHBROOK, IL 60062-6194
(224) 330-6300
(847) 854-9403

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036126943
IL
208000000X
Pediatrics Physician
125053988
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036126943
IL
01
05632081
BCBS OF IL
01
1477717213
TRICARE STANDARD
IL
Enumeration date
07/10/2008
Last updated
01/03/2022
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