Provider Demographics
NPI:1578870515
Name:GRUNST, JAMES (DPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:GRUNST
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 LAKEVIEW PKWY
Mailing Address - Street 2:STE 195
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1443
Mailing Address - Country:US
Mailing Address - Phone:847-247-7200
Mailing Address - Fax:847-247-4340
Practice Address - Street 1:935 LAKEVIEW PKWY
Practice Address - Street 2:STE 195
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1443
Practice Address - Country:US
Practice Address - Phone:847-247-7200
Practice Address - Fax:847-247-4340
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018118225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist