Provider Demographics
NPI:1194789990
Name:GROSSWEINER & BLASZAK, P.C.
Entity type:Organization
Organization Name:GROSSWEINER & BLASZAK, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIMBURGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-355-6660
Mailing Address - Street 1:1220 HOBSON RD STE 116
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-8137
Mailing Address - Country:US
Mailing Address - Phone:630-355-6660
Mailing Address - Fax:630-527-2856
Practice Address - Street 1:1220 HOBSON RD STE 116
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-8137
Practice Address - Country:US
Practice Address - Phone:630-355-6660
Practice Address - Fax:630-527-2856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty