Kenneth John Groh, P.T.
Individual provider Active NPI Physical Therapist · Lindenhurst, IL
NPI 1245328814 · NPPES record last updated Jul 2, 2012
Key facts
- NPI
- 1245328814
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070.009645 (IL)
- Practice address
- 1050 Red Oak LN
Therapy
Lindenhurst, IL 60046-4998 - Phone
- (847) 356-4750
- Fax
- (847) 356-4797
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.009645 | IL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.009645 | IL | Yes |
Addresses
Primary practice location
1050 Red Oak LN
Therapy
Lindenhurst, IL 60046-4998
Mailing address
1324 N Sheridan Rd
VSC Therapy
Waukegan, IL 60085-2161
Phone (847) 356-4750
Other providers in Lindenhurst, IL
- Genrikh Gandelsman DDS MSD LTD
- Brian C. Gniadek
- Richard L Goodson
- Jessica Goschy
- Michael J Granahan
- Lauren Gruber
- Ivalis Anita Guajardo
- Sarah Gurchak
- Janet Haro
- Heidi J Helgeson Donaubauer
All providers in Lindenhurst, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.