Individual
CHRISTINE GRUNDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 N MELVIN ST, GIBSON CITY, IL 60936-1477
(217) 784-4540
(217) 784-4542
Mailing address
1775 W DEMPSTER ST, 8 SOUTH, PARK RIDGE, IL 60068-1143
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
125060120
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036135199
—
IL
Enumeration date
03/27/2011
Last updated
08/19/2020
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