Sebastian, Gracykutty T

Sebastian, Gracykutty T is an individual health care provider with primary practice located at 4201 W Medical Center Dr , Mchenry IL 60050-8409. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Sebastian, Gracykutty T can be contacted via phone (815) 759-4323.

Contact Information

Primary practice address
4201 W Medical Center Dr Mchenry IL 60050-8409
Phone: (815) 759-4323
Fax: (815) 759-4948
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209-007338 Illinois

Profile Details

NPI number 1629375985
LBN Legal business name Sebastian, Gracykutty T
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2011
Last updated Apr 21st, 2021 - about 4 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 1629375985 NPPES
Illinois Other 209007338 STATE LICENSE

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