Individual
IRMA GRANTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 S MAIN ST STE 309, LOMBARD, IL 60148-5366
(773) 966-2762
Mailing address
2200 S MAIN ST STE 309, LOMBARD, IL 60148-5366
(773) 966-2762
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/27/2018
Last updated
12/27/2018
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