Emilye Jessica Grant in Decatur - Medical
Emilye Jessica Grant - NPI 1396721189
Emilye Jessica Grant is a Medical in Decatur, Illinois. Emilye Jessica Grant practices all healthcare services and medical treatments related to Medical. The NPI Number for Emilye Jessica Grant is 1396721189. The last update date is 2015-07-24.
Emilye Jessica Grant's current location address is 1750 E Lake Shore Dr, Decatur, Illinois. You can contact this provider via phone number 2174641750 and fax number 2174641469. The mailing address for Emilye Jessica Grant is 1750 E Lake Shore Dr, Decatur, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Emilye Jessica Grant |
|---|---|
| Address | 1750 E Lake Shore Dr, Decatur, Illinois |
| Phone Number | 2174641750 |
| Fax Number | 2174641469 |
| Sole Proprietor | N |
| Credentials | PHYSICIAN |
NPI Number Detail
| NPI Number | 1396721189 |
|---|---|
| Provider Enumeration Date | 2005-12-22 |
| Last Updated Date | 2015-07-24 |
Provider Mailing Address Detail
| Address | 1750 E Lake Shore Dr |
|---|---|
| City | Decatur |
| State | Illinois (IL) |
| Post Code | 625213803 |
| Phone Number | 2174641750 |
| Fax Number | 2174641469 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | PA30148 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1027626 | LA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Emilye Jessica Grant by the Centers for Medicare & Medicaid Services?
The Emilye Jessica Grant has been issued the NPI (National Provider Identifier) 1396721189, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Emilye Jessica Grant's physical address?
The Emilye Jessica Grant is physically located at 1750 E Lake Shore Dr, in the city of Decatur, IL, with the postal code 625213803.
What is Emilye Jessica Grant's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Emilye Jessica Grant is Medical, and the taxonomy code that categorizes this field of expertise is 363Am0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1396721189 to Emilye Jessica Grant?
The Centers for Medicare & Medicaid Services originally issued the 1396721189 to Emilye Jessica Grant on 2005-12-22.
When was the information related to Emilye Jessica Grant most recently updated or refreshed?
The details pertaining to the Emilye Jessica Grant, including its address, specialty, and other relevant information, were last updated or refreshed on 2015-07-24.