Provider Demographics
NPI:1548383805
Name:GRASSO, JOSEPH S (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:S
Last Name:GRASSO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:33 WEST HIGGINS ROAD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010
Mailing Address - Country:US
Mailing Address - Phone:847-426-9000
Mailing Address - Fax:847-426-9050
Practice Address - Street 1:33 WEST HIGGINS ROAD
Practice Address - Street 2:SUITE 600
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010
Practice Address - Country:US
Practice Address - Phone:847-426-9000
Practice Address - Fax:847-426-9050
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2010-05-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-108340207Q00000X
NH10618207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF40409Medicare UPIN