Individual
JEFFREY GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6525 N MOZART ST, APT 3, CHICAGO, IL 60645-4377
(248) 761-6628
Mailing address
NMH/ARKES FAMILY PAVILION SUITE 1820, 676 N SAINT CLAIR, CHICAGO, IL 60611
(312) 926-2520
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
125066687
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/15/2015
Last updated
03/08/2016
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