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General NPI Number Information
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NPI Number | 1568458776
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Entity Type | Individual
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Provider Name | MARK S. GROSS M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 27401 W HIGHWAY 22 STE 125
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City | BARRINGTON
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State | IL
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Zip | 60010-5934
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Country | US
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Telephone | 847-381-0388
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Fax | 847-381-0811
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Provider Business Mailing Address
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Address Line | 900 RAND RD STE 300
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City | DES PLAINES
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State | IL
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Zip | 60016-2359
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Country | US
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Telephone | 847-324-3976
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Fax | 847-929-1154
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 036062557
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License Number State | IL
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