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Individual

DIANNE GROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3703 W LAKE AVE, SUITE 200, GLENVIEW, IL 60026-5823
(847) 998-1188
Mailing address
2635 S LOMBARD AVE, CICERO, IL 60804-3052

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
57.002024
IL

Other

Enumeration date
03/17/2009
Last updated
03/17/2009
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