Individual
DR. GRACE CHABALA CHIBESAKUNDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2401 W MAIN ST, VA MEDICAL CENTER, MARION, IL 62959-1188
(618) 998-5622
Mailing address
2201 BRENTWOOD DR, MARION, IL 62959-1496
(312) 543-7217
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036123270
IL
207R00000X
Internal Medicine Physician
125050637
IL
207RN0300X
Nephrology Physician
Primary
036123270
IL
Other
Enumeration date
07/24/2007
Last updated
03/24/2016
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