Individual
DR. MILES WILLIAM GRUNVALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5841 S MARYLAND AVE # MC6040, CHICAGO, IL 60637-1443
(773) 702-6337
Mailing address
180 HARVESTER DR STE 110, BURR RIDGE, IL 60527-6686
(773) 702-1150
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
036.170115
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2018
Last updated
07/22/2024
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