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MR. PAUL LEONARD GRINDSTAFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
750 EAST TERRA COTTA AVE, SUITE A, CRYSTAL LAKE, IL 60014
(815) 455-1800
(815) 455-1875
Mailing address
750 E TERRA COTTA AVE STE A, CRYSTAL LAKE, IL 60014-3621
(815) 455-1800
(815) 455-1875

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
336071769
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036110902
STATE LICENSE
IL
05
336071769
IL
Enumeration date
05/15/2006
Last updated
10/19/2018
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