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General NPI Number Information
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NPI Number | 1194789990
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Entity Type | Organization
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Legal Business Name | GROSSWEINER & BLASZAK, P.C.
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 1220 HOBSON RD STE 116
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City | NAPERVILLE
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State | IL
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Zip | 60540-8137
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Country | US
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Telephone | 630-355-6660
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Fax | 630-527-2856
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Provider Business Mailing Address
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Address Line | 1220 HOBSON RD STE 116
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City | NAPERVILLE
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State | IL
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Zip | 60540-8137
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Country | US
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Telephone | 630-355-6660
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Fax | 630-527-2856
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | LAURA HEIMBURGER
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Credential |
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Telephone | 630-355-6660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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