Individual
DR. CONRAD GRANT VANHAZEBROECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
800 BIESTERFIELD RD, ELK GROVE VILLAGE, IL 60007-3361
(847) 981-3599
Mailing address
800 BIESTERFIELD RD, ELK GROVE VILLAGE, IL 60007-3361
(847) 981-3599
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036124591
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/07/2007
Last updated
08/17/2016
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