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Individual

DANIEL V GRUNERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
127 CAPISTA DR, SHOREWOOD, IL 60404-8551
(815) 609-6150
(219) 203-2925
Mailing address
127 CAPISTA DR, SHOREWOOD, IL 60404-8551
(815) 609-6150
(219) 203-2925

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038007034
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04915367
BLUE SHIELD
IL
01
1285628479
NATIONAL PROVIDER IDENTIFIER
IL
Enumeration date
09/02/2005
Last updated
11/06/2014
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