Gruszka, Mary Ellen

Gruszka, Mary Ellen is an individual health care provider with primary practice located at 8711 W Cermak Rd , North Riverside IL 60546-1166. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Gruszka, Mary Ellen can be contacted via phone (708) 442-7979.

Contact Information

Primary practice address
8711 W Cermak Rd North Riverside IL 60546-1166
Phone: (708) 442-7979
Fax: (708) 442-8574
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036061958 Illinois

Profile Details

NPI number 1073506101
LBN Legal business name Gruszka, Mary Ellen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Jun 29th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1073506101 NPPES
Illinois MEDICAID 036061958

Popular Providers