Graba, Sandra Lukic

Graba, Sandra Lukic is an individual health care provider with primary practice located at 525 E Congress Pkwy , Crystal Lake IL 60014-6245. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Graba, Sandra Lukic can be contacted via phone (815) 459-6780.

Contact Information

Primary practice address
525 E Congress Pkwy Crystal Lake IL 60014-6245
Fax: (815) 459-1648
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 125053988 Illinois
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036126943 Illinois

Profile Details

NPI number 1477717213
LBN Legal business name Graba, Sandra Lukic
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2008
Last updated Jan 3rd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477717213 NPPES
Illinois MEDICAID 036126943
Illinois Other 05632081
Illinois Other 1477717213

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