NPIMap

Organization Active NPI

Dr. Michael H. Grousd DDS Ma LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Vernon Hills, IL
National Provider Identifier
1972656890
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
DR. MICHAEL H. GROUSD DDS MA LTD
Practice address
1 E Phillip Rd
Suite 101
Vernon Hills, IL 60061-1858
Phone
(847) 367-4190
Fax
(847) 367-5010
NPI assigned
Jan 22, 2007
Last updated
Dec 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Authorized official

Name
Linda L McManamon
Title
Manager
Phone
(847) 367-4190

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X IL Primary

Addresses

Primary practice location

1 E Phillip Rd
Suite 101
Vernon Hills, IL 60061-1858

Mailing address

1 E Phillip Rd
Suite 101
Vernon Hills, IL 60061-1858
Phone (847) 367-4190

Other identifiers 1

IdentifierTypeStateIssuer
80022385OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1972656890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E PHILLIP RD",
            "address_2": "SUITE 101",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611858",
            "telephone_number": "847-367-4190",
            "fax_number": "847-367-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E PHILLIP RD",
            "address_2": "SUITE 101",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611858",
            "telephone_number": "847-367-4190",
            "fax_number": "847-367-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MICHAEL H. GROUSD DDS MA LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "MCMANAMON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-367-4190"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80022385",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.