Individual
AMANDA MARIE GRUBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
240 ADDISON RD, RIVERSIDE, IL 60546-2039
(708) 476-3089
Mailing address
240 ADDISON RD, RIVERSIDE, IL 60546-2039
(708) 476-3089
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/23/2026
Last updated
04/23/2026
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