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NPI Code Detail

MEDICARE: GRACE NABIL JOSEPH M.D.

MEDICARE: GRACE NABIL JOSEPH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianBP10057170TX
2207P00000XEmergency Medicine Physician036154482IL
3390200000XStudent in an Organized Health Care Education/Training Program
4207P00000XEmergency Medicine Physician4745320WI

General Provider Information

NPI Number : 1245694090
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE NABIL JOSEPH M.D.
Provider Business Mailing Address
First Line : 5645 W ADDISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60634-2881
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5645 W ADDISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60634-2881
Country : US
Telephone Number : 773-794-7601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2016
Last Update Date : 04/10/2026

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Directions to “ GRACE NABIL JOSEPH M.D.” Practice Location

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