Edward Gronko, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085004354 Issued in IL

Practice address

4711 Golf Rd
Suite 1050
Skokie, IL 60076-1224

Phone

(224) 251-7246

Fax

(224) 534-7431

NPI assigned

Jan 24, 2013

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)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1760720734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD",
            "address_2": "SUITE 1050",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761224",
            "telephone_number": "630-202-2087",
            "fax_number": "224-534-7431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD",
            "address_2": "SUITE 1050",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761224",
            "telephone_number": "224-251-7246",
            "fax_number": "224-534-7431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONKO",
        "first_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-24",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Griffin, LCSW
• Madelene L R Grimm, APN
• Jeffrey Allen Grinblatt, MD
• Karen L Grinnen, PHARMD
• Alexis Tara Grinstein, M.A., BCBA
• Maria Grosu
• Campsie Grothendieck
• Grove of Skokie Living and Rehab Center, LLC
• Delia Mihaela Groza, APN
• Jeffrey Grubba, SA

• Physician Assistant in Skokie, IL
• Providers in Skokie, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.