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130 S Il Route 83 Grayslake IL 60030-1620 | |
| (847) 856-3800 | |
| (847) 856-3803 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 130 S Il Route 83, Grayslake, Illinois |
| Authorized Official Name and Position | James A Gross (PRESIDENT) |
| Authorized Official Contact | 8478563800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 40 Round Lake IL 60073-0040 Ph: (847) 856-3800 | 130 S Il Route 83 Grayslake IL 60030-1620 Ph: (847) 856-3800 |
| NPI Number | 1558691949 |
|---|---|
| Provider Enumeration Date | 01/06/2010 |
| Last Update Date | 12/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558691949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 036072198 (Illinois) | Primary |
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