Individual
DR. BILL H GRIMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
6912 MAIN ST, SUITE 29, DOWNERS GROVE, IL 60516-3447
(630) 963-9381
(815) 254-0635
Mailing address
13114 SHREFFLER DR, PLAINFIELD, IL 60585-7867
(815) 254-0634
(815) 254-0635
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022-73039
BCBSIL PROVIDER NUMBER
IL
01
—
281045
VALUEOPTIONS PROVIDER NO.
IL
Enumeration date
06/05/2007
Last updated
07/08/2007
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