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Mr. Dale Forrest Grooms, ATC
Student in an Organized Health Care Education/Training Program in Winnetka, Illinois
NPI 1962581660

Dale Forrest Grooms is a Student in an Organized Health Care Education/Training Program based in Winnetka, IL. Dale Forrest Grooms practices in Winnetka, IL and has the professional credentials of ATC. The NPI Number for Dale Forrest Grooms is 1962581660 and holds a License No. 96000739 (Illinois).

The current practice location address for Dale Forrest Grooms is 385 Winnetka Ave, Winnetka, IL and can be reached out via phone at 847-501-6445 and via fax at 847-446-8247. You can also correspond with Dale Forrest Grooms through the mailing address at 385 WINNETKA AVE, WINNETKA, IL - 60093-4238 (mailing address contact number: 847-501-6445).

Location: 385 Winnetka Ave, Winnetka, IL, 60093-4238
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1962581660
Provider Name
Dale Forrest Grooms
Credential
ATC
Provider Entity Type
Individual
Gender
Male
Address
385 Winnetka Ave, Winnetka, IL, 60093-4238
Phone Number
847-501-6445
Fax Number
847-446-8247
Provider Enumeration Date
11/03/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
385 Winnetka Ave
City
Winnetka
State
Illinois
Zip
60093-4238
Phone Number
847-501-6445
Fax Number
847-446-8247
person
Provider Business Mailing Address Details
Address
385 Winnetka Ave
City
Winnetka
State
Illinois
Zip
60093-4238
Phone Number
847-501-6445
Fax Number
847-446-8247
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
96000739 (Illinois)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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