Grampsas, Samuel Anthony

Grampsas, Samuel Anthony is an individual health care provider with primary practice located at 1701 E College Ave , Bloomington IL 61704-2101. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Grampsas, Samuel Anthony can be contacted via phone (309) 664-3000.

Contact Information

Primary practice address
1701 E College Ave Bloomington IL 61704-2101
Phone: (309) 664-3000
Fax: (309) 664-3026
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 036104697 Illinois

Profile Details

NPI number 1386618833
LBN Legal business name Grampsas, Samuel Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Mar 17th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386618833 NPPES
Illinois Other 070519 HEALTH ALLIANCE
Illinois MEDICAID 036104697 HEALTH ALLIANCE
Illinois Other 340019436 HEALTH ALLIANCE
Illinois Other 364121826 07 HEALTH ALLIANCE

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