Search › Illinois › 207Q00000X

Clyde Grady

NPI 1851484075 · on the registry since 2006

Practice

Address
104 S Broad St
Knoxville, IL 61448
Phone
(309) 289-2335
Fax
(309) 289-8196
Organisation at this address
St Mary Medical Center
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
207Q00000X
207Q00000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois