Christopher Leon Grunow, PSY.D.
Individual provider Active NPI Clinical Psychologist · Lyons, IL
NPI 1730253154 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1730253154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- Practice address
- 4409 Joliet Ave
Lyons, IL 60534-1535 - Phone
- (708) 447-7240
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071005416 | IL | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | IL | Yes |
Addresses
Primary practice location
4409 Joliet Ave
Lyons, IL 60534-1535
Mailing address
4409 Joliet Ave
Lyons, IL 60534-1535
Phone (708) 447-7240
Other providers in Lyons, IL
- Florecemos Therapy, PLLC
- Lauren Darlene Frigo
- Rosemary Elizabeth Gahl
- Jeremy Glavanovits
- Brian Jesse Gomez
- Sammy I Hakky
- Kellie Halvey
- Saja Hamad
- Farah Hamada
- Shenna Harris
All providers in Lyons, IL · Clinical Psychologist 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 8, 2007. 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.