MEDICARE: LINDSEY GRAFF D.O.

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
1	207V00000X	Obstetrics & Gynecology Physician	1073907663	IL

General Provider Information

NPI Number	:	1073907663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY GRAFF D.O.

Provider Business Mailing Address
First Line	:	2801 LAKESIDE DR STE 209
Second Line	:
City	:	BANNOCKBURN
State	:	IL
Zip	:	60015-1271
Country	:	US
Telephone Number	:	847-562-1410
Fax Number	:	847-562-0830

Provider Business Practice Location Address
First Line	:	1435 N RANDALL RD STE 309
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60123-2304
Country	:	US
Telephone Number	:	847-741-7990
Fax Number	:	847-741-8099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2015
Last Update Date	:	12/21/2021

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