Provider Demographics
NPI:1619960184
Name:GRAUER, ARNOLD B (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:B
Last Name:GRAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 E ERIE ST
Mailing Address - Street 2:SUITE 710
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2926
Mailing Address - Country:US
Mailing Address - Phone:312-624-9671
Mailing Address - Fax:312-624-8849
Practice Address - Street 1:233 E ERIE ST
Practice Address - Street 2:SUITE 710
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2926
Practice Address - Country:US
Practice Address - Phone:312-624-9671
Practice Address - Fax:312-624-8849
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036039248207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036039248Medicaid
IL110087227OtherRR MEDICARE
ILL25620Medicare PIN
IL036039248Medicaid