Individual
DR. STEVEN LARRY GRYLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
676 N SAINT CLAIR ST, SUITE 1785, CHICAGO, IL 60611-2927
(312) 649-1054
(312) 573-1919
Mailing address
676 N SAINT CLAIR ST, SUITE 1785, CHICAGO, IL 60611-2927
(312) 649-1054
(312) 573-1919
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016-72606
BLUE CROSS BLUE SHIELD
—
01
—
5632281
AETNA
IL
Enumeration date
05/08/2006
Last updated
07/08/2007
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