NPI 1336855329

Charles Gordon Gronau, ACSMEPC

Practitioner Clinical Exercise Physiologist Chicago, IL

Practice location

Address: 1640 W Roosevelt Rd, Chicago, IL 60608-1316
Phone: (312) 413-8043
Mailing address: 40 E 9th St APT 512, Chicago, IL 60605-2142

Registered specialties

Clinical Exercise Physiologist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Y00000X Licence 1069105

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Registry record

NPI: 1336855329
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Jan 2023
Record last updated: 24 Jan 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.