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NPI Code Detail

MEDICARE: KEYERA GROSS APRN

MEDICARE:   KEYERA  GROSS  APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner209032624IL

General Provider Information

NPI Number : 1962384446
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEYERA GROSS APRN
Provider Business Mailing Address
First Line : 2800 W HIGGINS RD STE 650
Second Line :
City : HOFFMAN ESTATES
State : IL
Zip : 60169-7268
Country : US
Telephone Number : 815-947-4463
Fax Number :
Provider Business Practice Location Address
First Line : 2800 W HIGGINS RD STE 650
Second Line :
City : HOFFMAN ESTATES
State : IL
Zip : 60169-7268
Country : US
Telephone Number : 815-947-4463
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2025
Last Update Date : 07/24/2025

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Directions to “ KEYERA GROSS APRN” Practice Location

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