| Richard L Grant Md Pc | |
|
7309 N Knoxville Peoria IL 61614 | |
| (309) 692-5550 | |
| (309) 692-5553 |
| Full Name | Richard L Grant Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Forensic Psychiatry |
| Location | 7309 N Knoxville, Peoria, Illinois |
| Authorized Official Name and Position | Richard Locke Grant (PRESIDENT) |
| Authorized Official Contact | 3096925550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard L Grant Md Pc 709 Townes Court Peoria IL 61615-1381 Ph: (309) 692-5550 | Richard L Grant Md Pc 7309 N Knoxville Peoria IL 61614 Ph: (309) 692-5550 |
| NPI Number | 1114000536 |
|---|---|
| Provider Enumeration Date | 10/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114000536 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084F0202X | Psychiatry & Neurology - Forensic Psychiatry | (Illinois) | Primary |
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