Provider Demographics
NPI:1962866913
Name:GRUBBS, ALLISON ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:ELIZABETH
Last Name:GRUBBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:250 E SUPERIOR ST DEPT OBGYN
Mailing Address - Street 2:SUITE 5-2177
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2914
Mailing Address - Country:US
Mailing Address - Phone:312-472-4673
Mailing Address - Fax:312-472-4687
Practice Address - Street 1:250 E SUPERIOR ST DEPT OBGYN
Practice Address - Street 2:SUITE 5-2177
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2914
Practice Address - Country:US
Practice Address - Phone:312-472-4673
Practice Address - Fax:312-472-4687
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036152844207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program