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NPI Code Detail

MEDICARE: ABIGAIL GRACE ROYCRAFT

MEDICARE: ABIGAIL GRACE ROYCRAFT
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
1225100000XPhysical Therapist070-028235IL

General Provider Information

NPI Number : 1174370639
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL GRACE ROYCRAFT
Provider Business Mailing Address
First Line : 2122 YORK RD STE 300
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1925
Country : US
Telephone Number : 630-575-6200
Fax Number :
Provider Business Practice Location Address
First Line : 500 N KINGSBURY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60654-5721
Country : US
Telephone Number : 312-527-5801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2024
Last Update Date : 03/18/2026

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Directions to “ ABIGAIL GRACE ROYCRAFT ” Practice Location

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