Dr Anthony M Grimaldi, DO | |
20201 Crawford Ave, Suite 1276, Olympia Fields, IL 60461-1010 | |
(708) 679-2270 | |
(708) 679-2272 |
Full Name | Dr Anthony M Grimaldi |
---|---|
Gender | Male |
Speciality | Urology |
Location | 20201 Crawford Ave, Olympia Fields, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811048812 | NPI | - | NPPES |
BLUE CROSS BLUE SHIE | Other | IL | 21626252 |
203979055 | Other | IL | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 036053826 (Illinois) | Primary |
Entity Name | Anthony M Grimaldi, Do Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982755997 PECOS PAC ID: 2860524634 Enrollment ID: O20100714000061 |
Mailing Address | Practice Location Address |
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Dr Anthony M Grimaldi, DO 1040 Sierra Dr, Suite 400, Greenwood, IN 46143-7240 Ph: (317) 528-4253 | Dr Anthony M Grimaldi, DO 20201 Crawford Ave, Suite 1276, Olympia Fields, IL 60461-1010 Ph: (708) 679-2270 |
Shahrokh N Kayhan, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 20201 Crawford Ave, Suite 1276, Olympia Fields, IL 60461 Phone: 555-555-5555 Fax: 555-555-5554 | |
Melissa Mae Kilianek, Urology Medicare: Not Enrolled in Medicare Practice Location: 20201 Crawford Ave, Olympia Fields, IL 60461 Phone: 708-855-7021 |