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General NPI Number Information
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NPI Number | 1316682685
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Entity Type | Individual
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Provider Name | ZACHARY GROSS DO
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Gender | Male
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 1775 DEMPSTER ST MAILBOX #48
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City | PARK RIDGE
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State | IL
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Zip | 60068
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Country | US
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Telephone | 708-684-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 441 E ERIE ST APT 2607
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City | CHICAGO
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State | IL
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Zip | 60611-7126
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Country | US
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Telephone | 224-829-8833
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 125.079951
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License Number State | IL
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