Individual
REBECCA E GRAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
225 E CHICAGO AVE, BOX #152, CHICAGO, IL 60611-2991
(312) 227-7413
(312) 227-9525
Mailing address
225 EAST CHICAGO AVE., BOX #152, CHICAGO, IL 60611-2605
(312) 227-7413
(312) 227-9525
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-110862
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021622158
CMMG BLUE SHIELD
IL
01
—
1992758544
CMMG NPI
IL
Enumeration date
05/24/2006
Last updated
01/14/2013
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