Doctor Name: | JAMES L GRECO |
NPI Number: | 1043205248 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 036-056023 |
Business Practice Address: | 6723 Roosevelt Rd Berwyn, IL - 604021007 |
Business Phone Number: | 7084846680 |
Business Fax Number: | 7084846230 |
Mailing Address: | 6723 Roosevelt Rd, BERWYN |
State: | IL |
Postal Code: | 604021007 |
Phone Number: | 7084846680 |
Fax Number: | 7084846230 |
NPI Enumeration Date: | 09/14/2005 |
NPI Last Update Date: | 02/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | 036-056023 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |