Individual
SCOTT EVAN GROSSBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
250 E PEARSON ST, CHICAGO, IL 60611-7225
(312) 540-3881
Mailing address
250 E PEARSON ST, CHICAGO, IL 60611-7225
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A95432
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A954320
—
CA
Enumeration date
06/19/2006
Last updated
08/10/2016
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