Provider Demographics
NPI:1558691949
Name:CLINICIANS CLINICS OF AMERICA LLC
Entity Type:Organization
Organization Name:CLINICIANS CLINICS OF AMERICA LLC
Other - Org Name:JAMES A GROSS MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-856-3800
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60073-0040
Mailing Address - Country:US
Mailing Address - Phone:847-856-3800
Mailing Address - Fax:847-856-3803
Practice Address - Street 1:130 S IL ROUTE 83
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1620
Practice Address - Country:US
Practice Address - Phone:847-856-3800
Practice Address - Fax:847-856-3803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036072198207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty