| Gvd Podiatry Healthcare Pc | |
|
1079 South Myrtle Avenue, Kankakee, IL 60901-5457 | |
| (815) 932-8161 | |
| Not Available |
| Full Name | Gvd Podiatry Healthcare Pc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 1079 South Myrtle Avenue, Kankakee, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023128121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | (Illinois) | Primary |
| Provider Name | Grace V David |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1467562561 PECOS PAC ID: 8921046111 Enrollment ID: I20050419000746 |
| Mailing Address | Practice Location Address |
|---|---|
| Gvd Podiatry Healthcare Pc 1079 South Myrtle Avenue, Kankakee, IL 60901-5457 Ph: (815) 932-8161 | Gvd Podiatry Healthcare Pc 1079 South Myrtle Avenue, Kankakee, IL 60901-5457 Ph: (815) 932-8161 |
Dr. Robert Alan Raley, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 70 Meadowview Ctr, Suite 401, Kankakee, IL 60901 Phone: 815-932-1724 Fax: 815-932-1729 | |
Robert A. Raley Dpm Sc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 70 Meadowview Ctr, Suite 401, Kankakee, IL 60901 Phone: 815-932-1724 Fax: 815-932-1729 | |
Dr. Grace Victoria David, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1079 South Myrtle Avenue, Kankakee, IL 60901 Phone: 815-932-8161 Fax: 815-932-8161 |