Provider Demographics
NPI:1689603268
Name:ALEPPO, GRAZIA (MD)
Entity Type:Individual
Prefix:DR
First Name:GRAZIA
Middle Name:
Last Name:ALEPPO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GRAZIA
Other - Middle Name:
Other - Last Name:ALEPPO-KACMAREK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:675 N SAINT CLAIR ST
Mailing Address - Street 2:14-100
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5975
Mailing Address - Country:US
Mailing Address - Phone:312-695-7970
Mailing Address - Fax:312-695-4433
Practice Address - Street 1:675 N SAINT CLAIR ST
Practice Address - Street 2:GALTER- 14-100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5975
Practice Address - Country:US
Practice Address - Phone:312-695-7970
Practice Address - Fax:312-695-4433
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099550207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH47406Medicare UPIN