Roger C Gronau, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

527 W South St
Woodstock, IL 60098-3756

Phone

(815) 338-9199

Fax

(815) 338-9205

NPI assigned

Jul 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Horizons Behavioral Health LLC

  • Social Worker
  • Crystal Lake, IL
  • NPI 1881692689
  NPD (past)
• Mathers Clinic, LLC

  • Child & Adolescent Psychiatry Physician
  • Rockford, IL
  • NPI 1215194519
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992704225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 MCHENRY AVE",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147449",
            "telephone_number": "815-455-7100",
            "fax_number": "815-455-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 W SOUTH ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983756",
            "telephone_number": "815-338-9199",
            "fax_number": "815-338-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONAU",
        "first_name": "ROGER",
        "middle_name": "C",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1957-057",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05619771",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatiana Stephanie Gmitrovic
• Kathleen Golly
• Katharina Gounaris, BSW, CDVP
• Katherine J Graham, MSW, LSW
• Ashleigh Lucy Annette Gregory, BCBA
• Shannon Guzick, PTA
• Gyuzelev MD Surgical Assistance LLC
• Petar Gyuzelev, MD, RSA
• Melanie Hahndorf
• Meg M Hainer, MD

• Psychologist in Woodstock, IL
• Providers in Woodstock, IL by specialty
• Psychologist 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.