Provider Demographics
NPI:1760260269
Name:DEGRAFF, ABIGAIL JOY
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:JOY
Last Name:DEGRAFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 DEMPSTER ST
Mailing Address - Street 2:
Mailing Address - City:MT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-4978
Mailing Address - Country:US
Mailing Address - Phone:224-507-8815
Mailing Address - Fax:
Practice Address - Street 1:1585 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-4978
Practice Address - Country:US
Practice Address - Phone:224-507-8815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health