Provider Demographics
NPI:1619038411
Name:GROYA, ROBERT JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:GROYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 SHERWOOD CT.
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60526-1967
Mailing Address - Country:US
Mailing Address - Phone:708-482-8686
Mailing Address - Fax:708-482-8694
Practice Address - Street 1:348 SHERWOOD CT.
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526-1967
Practice Address - Country:US
Practice Address - Phone:708-482-8686
Practice Address - Fax:708-482-8694
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036045842207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
362920223OtherUNITED HEALTHCARE
362920223OtherUNITED HEALTHCARE
636070Medicare PIN