Individual
DR. DAMIAN W GRIVETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
309 S. MCCOY, GRANVILLE, IL 61326-9333
(815) 339-6245
(815) 339-2617
Mailing address
600 E 1ST ST, SPRING VALLEY, IL 61362-1512
(815) 339-6245
(815) 339-2617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036109350
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036109350
—
IL
Enumeration date
08/15/2006
Last updated
08/25/2008
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