Most Relevant Information
Provider Data
| NPI Number: | 1003463225 |
| Provider Name: | JASON GRAUER APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209.019859041.349810 |
Most Important Dates
| Enumeration Date: | 08/22/2019 |
| Last Updated: | 08/22/2019 |
Provider Practice Location
2300 N EDWARD ST
DECATUR
IL
625264192
Practice Location Phone/Fax
| Phone: | 2178768121 |
| Fax: |
Provider Mailing Location
6509 DAYBROOK DR
DECATUR
IL
625218727
Provider Mailing Phone/Fax
| Phone: | 2171411521 |
| Fax: |