Individual
DR. MARGO AIDAN GROMOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
1501 E GARDNER LN APT 718, PEORIA HEIGHTS, IL 61616-3627
(979) 966-3028
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
IL
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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