Provider Demographics
NPI:1730373747
Name:GRAZIANO, J JAMES (MD)
Entity type:Individual
Prefix:
First Name:J
Middle Name:JAMES
Last Name:GRAZIANO
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 1:2050 S FINLEY RD
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4837
Mailing Address - Country:US
Mailing Address - Phone:630-819-5600
Mailing Address - Fax:
Practice Address - Street 1:2050 S FINLEY RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4837
Practice Address - Country:US
Practice Address - Phone:630-819-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-03
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036124856207Q00000X
IL125052517390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program