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Contact Information

GRACE V DAVID, DPM
1079 SOUTH MYRTLE AVENUE
KANKAKEE, IL60901-5457
 Phone: 815-932-8161
 Fax: 815-932-8161
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for GRACE V DAVID · (Female)

NPI Number 1467562561
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 08/30/2006
Last updated 11/14/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 016004708
  • IL Medicaid 016004708
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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