Individual
CODY GROTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-1009
(217) 788-3000
Mailing address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036165091
IL
Other
Enumeration date
04/24/2019
Last updated
09/22/2023
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