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General NPI Number Information
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NPI Number | 1508144056
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Entity Type | Individual
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Provider Name | GRACE FRAZIER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/02/2011
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 4625 E MARYLAND ST
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City | DECATUR
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State | IL
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Zip | 62521-5092
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Country | US
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Telephone | 217-864-9288
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Fax | 217-864-6526
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Provider Business Mailing Address
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Address Line | 301 KINGS MANTLE CT
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City | MT ZION
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State | IL
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Zip | 62549-9725
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Country | US
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Telephone | 773-962-1765
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051.293475
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License Number State | IL
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