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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACKSON GRAVES, MD

Active Sole Proprietor

JACKSON GRAVES, MD is a Pediatrics healthcare provider located in PEORIA, Illinois. NPI 1740843127 is currently active in the NPPES registry. Verify at CMS.

Pediatrics · PEORIA, IL

Registration Details

NPI Number
1740843127
Provider Type
Individual
Gender
Male
NPI Issued
Apr 21, 2019 (7.2718177302049 yrs)
Last Updated
Feb 28, 2024
Licenses
036.162138 (IL)
036.162138 (IL)
Sole Proprietor
Yes

Practice Information

Address
530 NE GLEN OAK AVE
PEORIA, IL, 616370001
Browse IL providers · Browse ZIP 61637
Phone
3096552000
Primary Specialty
Pediatrics
208000000X
Additional Specialty
Pediatrics

Other Pediatrics Providers in PEORIA, IL

Name Credential NPI
DR. LORI ELIZABETH SIMENAUER M.D. 1780670794
JALAYNE M LAPKE MD 1508837758
DR. ALLEN LYNN NEESE M.D., PH.D. 1841261872
DR. HEATHER LEE DOEBLER MCCARTHY D.O. 1306819289
HEATHER MCLAUCHLAN MD 1356319479
CHANNING PETRAK MD 1952370538
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.