Provider Demographics
NPI:1063434256
Name:GROBER, JAMES STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:STEPHEN
Last Name:GROBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2650 RIDGE AVE
Mailing Address - Street 2:EVANSTON HOSPITAL
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-1206
Mailing Address - Fax:847-570-1248
Practice Address - Street 1:1000 CENTRAL ST
Practice Address - Street 2:SUITE 800
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1777
Practice Address - Country:US
Practice Address - Phone:847-570-1206
Practice Address - Fax:847-570-1248
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036082262207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1620385OtherBCBS PPO
IL660002720OtherRAILROAD MEDICARE
IL036-082262Medicaid
ILL77721Medicare PIN