Gronau, Roger C

Gronau, Roger C is an individual health care provider with primary practice located at 527 W South St , Woodstock IL 60098-3756. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Gronau, Roger C can be contacted via phone (815) 338-9199.

Contact Information

Primary practice address
527 W South St Woodstock IL 60098-3756
Phone: (815) 338-9199
Fax: (815) 338-9205
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1957-057 Wisconsin
Behavioral Health & Social Service Providers / Psychologist 103T00000X Illinois

Profile Details

NPI number 1992704225
LBN Legal business name Gronau, Roger C
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Jul 8th, 2007 - about 18 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 1992704225 NPPES
Illinois Other 05619771 BCBS

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