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General NPI Number Information
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NPI Number | 1841146453
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Entity Type | Organization
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Legal Business Name | GRAHAM HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 03/06/2026
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | GMG SOUTH - PRIMARY & CONVENIENT CARE 455 E 3RD ST
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City | GALESBURG
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State | IL
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Zip | 61401
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Country | US
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Telephone | 309-570-1333
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Fax |
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Provider Business Mailing Address
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Address Line | 210 W WALNUT ST
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City | CANTON
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State | IL
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Zip | 61520-2497
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Country | US
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Telephone | 309-647-5240
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JULIE REEDER
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Credential |
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Telephone | 309-647-5240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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