Individual
DR. JEFFREY ALLEN GRINBLATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9669 KENTON AVE, SUITE 203, SKOKIE, IL 60076-1266
(847) 677-0212
Mailing address
6148 N MONTICELLO AVE, CHICAGO, IL 60659-1113
(773) 539-0642
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036081091
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031603918
BLUE CROSS BLUE SHIELD
IL
05
—
036081091
—
IL
Enumeration date
08/01/2006
Last updated
07/08/2007
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