NPI 1003149766

Rita Rae Graham, NCTMB

Practitioner Specialist Libertyville, IL

Practice location

Address: 1244 American Way, Libertyville, IL 60048-3936
Phone: (847) 549-9595
Fax: (847) 549-9596

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 227008684 (IL)

Other Specialist providers in Illinois →

Registry record

NPI: 1003149766
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Sep 2009
Record last updated: 14 Sep 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.