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Individual

DR. ANTHONY M GRIMALDI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
20201 CRAWFORD AVE, SUITE 1276, OLYMPIA FIELDS, IL 60461-1010
(708) 679-2270
(708) 679-2272
Mailing address
1040 SIERRA DR, SUITE 400, GREENWOOD, IN 46143-7240
(317) 528-4253
(317) 865-8319

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036053826
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
203979055
MEDICARE PTAN
IL
01
BLUE CROSS BLUE SHIE
21626252
IL
Enumeration date
01/16/2007
Last updated
12/03/2015
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