Individual
THOMAS GROBELNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1700 LUTHER LN STE 1170, PARK RIDGE, IL 60068-1270
(844) 376-3876
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036114911
IL
2085R0202X
Diagnostic Radiology Physician
04-28765
KS
2085R0202X
Diagnostic Radiology Physician
200155001
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114911
—
IL
Enumeration date
03/06/2006
Last updated
04/20/2022
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