Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Brent Thomas Graceffa, IDC

Individual provider Independent Duty Corpsman · NPI 1306255641

Brent Thomas Graceffa, IDC is an Independent Duty Corpsman in Rockton, Illinois. Practices as a sole proprietor. Registered with an NPI since 2014.

In the registry since
2014
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Practice location Address checks out

107 Strawbridge Dr
Rockton, IL 61072-2957
Phone: (760) 212-1995
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X

Record details

NPI number1306255641
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorYes
NPI enumeratedAugust 12, 2014
Last updated in NPPESAugust 12, 2014