Individual
FELIPE GRACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17495 LA GRANGE RD, TINLEY PARK, IL 60487-7581
(815) 416-6641
(630) 432-6604
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
036088774
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020041803
RAILROAD MEDICARE
IL
05
—
036088774
—
IL
Enumeration date
10/13/2005
Last updated
08/08/2023
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