Grennan, Dara

Grennan, Dara is an individual health care provider with primary practice located at 403 E 1St St , Dixon IL 61021. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is her primary health care specialty. Grennan, Dara can be contacted via phone (815) 285-5629.

Contact Information

Primary practice address
403 E 1St St Dixon IL 61021
Phone: (815) 285-5629
Fax: (815) 285-5634
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-137502 Illinois
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 8153445 Utah
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 36.137502 Illinois
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 036-137502 Illinois

Profile Details

NPI number 1518282938
LBN Legal business name Grennan, Dara
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2010
Last updated Apr 26th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518282938 NPPES
Illinois Other F400440732 MEDICARE PTAN
Illinois MEDICAID 036137502 MEDICARE PTAN

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