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Contact Information

CHARLES G GROEN, MD
8915 W GOLF RD
3RD FLOOR
NILES, IL60714-5905
 Phone: 847-827-9490
 Fax: 847-827-2241
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
Indicates primary specialty

NPI Profile & details for CHARLES G GROEN · (Male)

NPI Number 1497742860
Status Active
Credentials MD
Entity Individual
Enumeration date 09/30/2005
Last updated 11/04/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036085244
  • IN License # 01068054A
  • IL Medicaid 036085244
  • IN Medicaid 201034800
  • IN Other 000000726585 ANTHEM PROVIDER NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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