Individual
GENA GROSPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2323 GRAND AVE, WAUKEGAN, IL 60085-3312
(847) 666-3494
Mailing address
2323 GRAND AVE, WAUKEGAN, IL 60085-3312
(847) 666-3494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036152298
IL
207Q00000X
Family Medicine Physician
125069990
IL
Other
Enumeration date
05/07/2017
Last updated
08/09/2021
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