Whalio Doctors

NPI 1215016662

Michael Samuel Grossman, MD

Practitioner Ophthalmology Physician Peoria, IL

Practice location

Address
4505 N Rockwood Dr, Peoria, IL 61615-3803
Phone
(309) 589-1880
Mailing address
3602 Marquette Rd, Peru, IL 61354-1450

Registered specialties (4)

Ophthalmology Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 207W00000X Licence 036128242 (IL)
Surgery Physician
Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 29207 (SC)
Ophthalmology Physician
Allopathic & Osteopathic Physicians Taxonomy 207W00000X Licence 202629 (LA)
General Practice Physician
Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 036128242 (IL)

Registry record

NPI
1215016662
Entity type
Individual
Sex (as registered)
Male
NPI issued
6 Nov 2006
Record last updated
6 Jun 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.