MEDICARE: MR. ALLEN D GRABER RPH, MPH

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
1	183500000X	Pharmacist		IL

General Provider Information

NPI Number	:	1316939390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALLEN D GRABER RPH, MPH

Provider Business Mailing Address
First Line	:	4409 HAMMERSMITH LN
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-1090
Country	:	US
Telephone Number	:	847-299-3051
Fax Number	:

Provider Business Practice Location Address
First Line	:	4409 HAMMERSMITH LN
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-1090
Country	:	US
Telephone Number	:	847-299-3051
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	02/08/2008

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