Individual
CHRISTINE M GROSSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
2003 W FULTON ST, STE 105, CHICAGO, IL 60612-2345
(312) 850-3438
Mailing address
2003 W FULTON ST, STE 105, CHICAGO, IL 60612-2345
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.005560
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164.005560
LICENSE #
IL
Enumeration date
07/31/2012
Last updated
07/31/2012
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