Provider Demographics
NPI:1437554342
Name:GRABER ORTHODONTICS
Entity Type:Organization
Organization Name:GRABER ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:GRABER
Authorized Official - Last Name:EVARTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:847-367-4920
Mailing Address - Street 1:830 W END CT
Mailing Address - Street 2:175
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1365
Mailing Address - Country:US
Mailing Address - Phone:847-367-4920
Mailing Address - Fax:
Practice Address - Street 1:830 W END CT
Practice Address - Street 2:175
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1365
Practice Address - Country:US
Practice Address - Phone:847-367-4920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060001911261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental