Individual
ROGER C GRONAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
527 W SOUTH ST, WOODSTOCK, IL 60098-3756
(815) 338-9199
(815) 338-9205
Mailing address
970 MCHENRY AVE, CRYSTAL LAKE, IL 60014-7449
(815) 455-7100
(815) 455-3951
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1957-057
WI
103T00000X
Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05619771
BCBS
IL
Enumeration date
07/19/2005
Last updated
07/08/2007
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