Jackson Graves, MD

Pediatrics Physician · Peoria, IL

Individual Active NPI

NPI number 1740843127

Practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 655-2000

Open in Google Maps

NPI record

NPI
1740843127
Entity type
Individual (Type 1)
Enumeration date
April 21, 2019
Last updated
February 28, 2024
Certified
February 28, 2024
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatrics Physician Primary 208000000X 036.162138 IL
Internal Medicine Physician 207R00000X 036.162138 IL

About Dr. Graves

Jackson Graves, MD is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatrics Physician (code 208000000X). The practice location is 530 NE Glen Oak Ave, Peoria, IL 61637-0001. The NPI number 1740843127 was assigned on April 21, 2019 and the record was last updated on February 28, 2024.

Dr. Graves lists 2 licenses in the registry: #036.162138 (IL) for Pediatrics Physician; #036.162138 (IL) for Internal Medicine Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jackson Graves, MD?

The NPI number is 1740843127.

What is the phone number of Dr. Graves?

The phone number listed for the practice location is (309) 655-2000.

Where is Dr. Graves located?

530 NE Glen Oak Ave, Peoria, IL 61637-0001.

What is the taxonomy code for Dr. Graves?

The primary taxonomy code is 208000000X – Pediatrics Physician; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other Pediatrics Physician providers in Peoria

All Pediatrics Physician providers in Peoria, IL →