Individual
DR. CHARLES R GRUNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 AUSTIN ST, EAST TOWER, SUITE 563, EVANSTON, IL 60202-3439
(847) 869-0522
(847) 869-0652
Mailing address
800 AUSTIN ST, EAST TOWER, SUITE 563, EVANSTON, IL 60202-3439
(847) 869-0522
(847) 869-0652
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036115417
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036115417
—
IL
Enumeration date
04/23/2008
Last updated
10/19/2011
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