Provider Demographics
NPI:1114112265
Name:GREBY, CARLA (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:
Last Name:GREBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:KEWANEE
Mailing Address - State:IL
Mailing Address - Zip Code:61443-2905
Mailing Address - Country:US
Mailing Address - Phone:309-852-3165
Mailing Address - Fax:309-852-3199
Practice Address - Street 1:2021 KENTVILLE RD
Practice Address - Street 2:IYC KEWANEE
Practice Address - City:KEWANEE
Practice Address - State:IL
Practice Address - Zip Code:61443
Practice Address - Country:US
Practice Address - Phone:309-852-4601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine