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Contact Information

MARY D DEGROOT, DPM
1938 E LINCOLN HWY
SUITE 206
NEW LENOX, IL60451-3810
 Phone: 815-462-9225
 Fax: 815-462-5385
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for MARY D DEGROOT · (Female)

NPI Number 1720071970
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 08/23/2005
Last updated 01/26/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 016005141
  • IL Medicaid 016005141
  • IL Other 01634686 BCBS
  • IL Other P00194730 RAILROAD MEDICARE
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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