Healthcare Provider Details

I. General information

NPI: 1114503042
Provider Name (Legal Business Name): ROSS TAYLOR GROESCHL DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 ESSINGTON RD
JOLIET IL
60435-8439
US

IV. Provider business mailing address

900 RAND RD STE 300
DES PLAINES IL
60016-2359
US

V. Phone/Fax

Practice location:
  • Phone: 815-744-4551
  • Fax: 815-744-4756
Mailing address:
  • Phone: 847-324-3976
  • Fax: 847-929-1154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1351
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number016-006081
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: