Grace Ann Kao, M.D.

Individual provider Active NPI Pediatrics Physician · Lindenhurst, IL

NPI 1003160243 · NPPES record last updated Nov 8, 2012

Key facts

NPI
1003160243
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
036.094795 (IL)
Practice address
2031 E Grand Ave
#200
Lindenhurst, IL 60046-9041
Phone
(847) 356-5575
Fax
(847) 356-1792
NPI assigned
Nov 8, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.094795ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amg Illinois LTD Past Accepting new patients
Amg Illinois LTD Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036.094795 IL Yes

Addresses

Primary practice location

2031 E Grand Ave
#200
Lindenhurst, IL 60046-9041

Mailing address

2031 E Grand Ave
#200
Lindenhurst, IL 60046-9041
Phone (847) 356-5575

Other names

  • Grace Ann Kuo Former name

Other providers in Lindenhurst, IL

All providers in Lindenhurst, IL · Pediatrics Physician in Illinois

Sources for this page

Verify at the official NPI Registry.