Dennis Anthony Grollo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Practice address

535 W Park Ave
Libertyville, IL 60048-2600

Phone

(847) 362-2311

Fax

(847) 362-2369

NPI assigned

Nov 17, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dennis Anthony Grollo Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306919147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 W PARK AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482600",
            "telephone_number": "847-362-2311",
            "fax_number": "847-362-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W PARK AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482600",
            "telephone_number": "847-362-2311",
            "fax_number": "847-362-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROLLO",
        "first_name": "DENNIS",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENNIS",
            "last_name": "GROLLO",
            "middle_name": "ANTHONY",
            "credential": "MDSC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Margot Greenwald, CCC-SLP
• Alison Greissinger
• Gretchen Clemens, LCSW
• Marni S Griffith, MHC, CCC-SLP
• Tiffany Grinter
• Growth Psychological Services Evaluations PLLC
• Eileen Magno Grubb, MD
• Lina Gudauskas, NP
• Daniel Guerrero
• Paloma Guijarro Ontiveros

• Family Medicine Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.