Healthcare Provider Details

I. General information

NPI: 1164098125
Provider Name (Legal Business Name): GRACE CHABAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E POLK ST
WASHINGTON IA
52353-1254
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-653-5481
  • Fax:
Mailing address:
  • Phone: 319-356-2294
  • Fax: 319-384-8620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberR-12410
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: