Charles Gordon Gronau II, ACSM EP-C

Primary specialty

Clinical Exercise PhysiologistTaxonomy code 224Y00000X

License

1069105

Practice address

1640 W Roosevelt Rd
Chicago, IL 60608-1316

Phone

(312) 413-8043

NPI assigned

Jan 24, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1336855329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E 9TH ST APT 512",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052142",
            "telephone_number": "618-746-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081316",
            "telephone_number": "312-413-8043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112991",
            "country_code": "US",
            "telephone_number": "312-227-3745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRONAU",
        "first_name": "CHARLES",
        "middle_name": "GORDON",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "ACSM EP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": null,
            "license": "1069105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet M Groll, OTRL
• Mary Elizabeth Groll, M.D.
• Jeffrey Daniel Grom, PHARMD
• Alexandria Gromala, PA-C
• Lori Ann Gromen, M.A. CCC-SLP
• Jessica Nicole Gronke
• Lauren Ann Gronowski, DROT, OTR/L
• Ellery Gronski, PA-C
• Vicki Lyn Groo, PHARMD
• Tatayana Groom

• Clinical Exercise Physiologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Exercise Physiologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.