Sebastian Graca, DMD is a medicare enrolled "Student In An Organized Health Care Education/training Program" provider in Chicago, Illinois. His current practice location is
1740 W Taylor St, Chicago, Illinois. You can reach out to his office (for appointments etc.) via phone at
(866) 600-2273.
Sebastian Graca is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1104445808.
Healthcare Provider's Profile
Full Name | Sebastian Graca |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1740 W Taylor St, Chicago, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1104445808
- Provider Enumeration Date: 04/13/2020
- Last Update Date: 07/14/2020
Medicare PECOS Information:
- PECOS PAC ID: 2668891250
- Enrollment ID: I20201001000021
Medical Identifiers
Medical identifiers for Sebastian Graca such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104445808 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 019.032604 (Illinois) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sebastian Graca is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Sebastian Graca, DMD 804 Sylviawood Ave, Park Ridge, IL 60068-2250 Ph: () - | Sebastian Graca, DMD 1740 W Taylor St, Chicago, IL 60612-7232 Ph: (866) 600-2273 |
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