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NPI Code Detail

MEDICARE: DR. MICHAEL BERNARD GRAHAM M.D.

MEDICARE:  DR. MICHAEL BERNARD GRAHAM  M.D.
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
1207R00000XInternal Medicine PhysicianIL

General Provider Information

NPI Number : 1023237591
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL BERNARD GRAHAM M.D.
Provider Business Mailing Address
First Line : 1009 WARRINGTON RD
Second Line :
City : DEERFIELD
State : IL
Zip : 60015-3343
Country : US
Telephone Number : 847-945-7315
Fax Number :
Provider Business Practice Location Address
First Line : 2775 SANDERS RD
Second Line : SUITE C1
City : NORTHBROOK
State : IL
Zip : 60062-6110
Country : US
Telephone Number : 847-402-8775
Fax Number : 847-326-9419
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 07/09/2007

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Directions to “ DR. MICHAEL BERNARD GRAHAM M.D.” Practice Location

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