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Individual
DANIEL V GRUNERT
Active
Individual
DANIEL V GRUNERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038007034
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04915367
BLUE SHIELD
IL
01
—
1285628479
NATIONAL PROVIDER IDENTIFIER
IL
Enumeration date
09/02/2005
Last updated
11/06/2014
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