Search › Illinois › 103T00000X
Dynesha Mason-Grissom, PH.D
NPI 1043789688 · on the registry since 2018
Practice
- Address
- 2500 Galen Dr Ste 104
Champaign, IL 61821 - Phone
- (217) 693-6072
- Organisation at this address
- Lawrence L Jeckel Md Pc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 6
Registry record
- Primary taxonomy
- 103T00000X
103T00000X
- Also registered as
- 103TC1900X
103TC2200X
103TF0000X - Sex
- Female
- Record last updated
- 2020-01-21
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