Individual
CHARLES G GROEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8915 W GOLF RD, 3RD FLOOR, NILES, IL 60714-5905
(847) 827-9490
(847) 827-2241
Mailing address
3610 PAYSPHERE CIR, CHICAGO, IL 60674-0036
(847) 585-7000
(847) 240-0622
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01068054A
IN
2085R0001X
Radiation Oncology Physician
036085244
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000726585
ANTHEM PROVIDER NUMBER
IN
05
—
036085244
—
IL
05
—
201034800
—
IN
Enumeration date
09/30/2005
Last updated
11/04/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us