Individual
DR. KENNETH A GRUMET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 AUSTIN ST STE 451, EVANSTON, IL 60202-3455
(847) 316-6600
(847) 316-6606
Mailing address
1000 REMINGTON BLVD STE 100, BOLINGBROOK, IL 60440-4707
(630) 914-2898
(630) 914-2469
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036063903
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275564940
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/05/2006
Last updated
03/17/2021
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