Individual
GRANT CONNELL HALLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(847) 723-2210
(847) 723-6987
Mailing address
1646 RIVER ST UNIT 701, DES PLAINES, IL 60016-8418
(858) 414-0117
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036.166239
IL
Other
Enumeration date
04/01/2020
Last updated
03/28/2024
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