Roger C Gronau in Crystal Lake - Psychologist
Roger C Gronau - NPI 1992704225
Roger C Gronau is a Psychologist in Crystal Lake, Illinois. Roger C Gronau practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Roger C Gronau is 1992704225. The last update date is 2007-07-08.
Roger C Gronau's current location address is 970 Mchenry Ave, Crystal Lake, Illinois. You can contact this provider via phone number 8154557100 and fax number 8154553951. The mailing address for Roger C Gronau is 970 Mchenry Ave, Crystal Lake, Illinois. To know further, please read the information below!
Provider Profile Detail
Provider Name | Roger C Gronau |
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Address | 970 Mchenry Ave, Crystal Lake, Illinois |
Phone Number | 8154557100 |
Fax Number | 8154553951 |
Sole Proprietor | N |
Credentials | PHD |
NPI Number Detail
NPI Number | 1992704225 |
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Provider Enumeration Date | 2005-07-19 |
Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
Address | 970 Mchenry Ave |
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City | Crystal Lake |
State | Illinois (IL) |
Post Code | 600147449 |
Phone Number | 8154557100 |
Fax Number | 8154553951 |
Provider's Primary Taxonomy Detail
Speciality | Psychologist |
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Taxonomy | 103T00000X |
Licence No | 1957-057 |
Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
5619771 | IL | BCBS |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Roger C Gronau by the Centers for Medicare & Medicaid Services?
The Roger C Gronau has been issued the NPI (National Provider Identifier) 1992704225 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Roger C Gronau?
The Roger C Gronau is situated at 970 Mchenry Ave, in the city of Crystal Lake, state of IL, with the zip code 600147449.
What is Roger C Gronau's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Roger C Gronau is Psychologist, and the corresponding taxonomy classification code for this specialized field is 103T00000X.
On what date did the Roger C Gronau receive its 1992704225 assignment from the Centers for Medicare & Medicaid Services?
The Roger C Gronau was assigned its 1992704225 by the Centers for Medicare & Medicaid Services on 2005-07-19.
As of what date were the Roger C Gronau's details last updated?
The information pertaining to the Roger C Gronau, including its address, specialty, and other details, was most recently updated on 2007-07-08.