Physician Compare National (NPI:1912003013)

HEALTHCARE PROVIDER: LAWRENCE VINCENT GRATKINS MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1912003013
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5799728101
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050608000062
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRATKINS
	Individual professional last name
Provider First Name	LAWRENCE
	Individual professional first name
Provider Middle Name	V
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	1977
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1300 FRANKLIN AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 270
	Group Practice or individual's line 2 address
City	NORMAL
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	617613691
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140127
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ADVOCATE BROMENN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	141317
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GIBSON COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y