Individual
GREGORY GRUENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAGUIRE CENTER, RM. 2700, MAYWOOD, IL 60153
(708) 216-2662
(708) 216-5617
Mailing address
2160 S 1ST AVE, MAGUIRE CENTER, RM. 2700, MAYWOOD, IL 60153
(708) 216-2662
(708) 216-5617
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
36064200
IL
2084N0600X
Clinical Neurophysiology Physician
36064200
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36064200
—
IL
Enumeration date
02/24/2006
Last updated
11/11/2021
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