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General NPI Number Information
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NPI Number | 1477105187
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Entity Type | Individual
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Provider Name | ANTHONY GREIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 540 LAKE COOK ROAD SUITE 300
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City | DEERFIELD
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State | IL
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Zip | 60015
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Country | US
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Telephone | 847-580-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 65 BENT CREEK RIDGE
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City | DEERFIELD
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State | IL
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Zip | 60015
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Country | US
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Telephone |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036058483
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License Number State | IL
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