Individual
ROBERT GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
990 ELK GROVE TOWN CTR, ELK GROVE VILLAGE, IL 60007-3754
(847) 290-1111
Mailing address
352 MARION AVE, GLEN ELLYN, IL 60137-4014
(608) 434-0081
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004363
IL
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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