Provider Demographics
NPI:1447470935
Name:GROTE, CHRISTOPHER LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:GROTE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1750 W HARRISON ST
Mailing Address - Street 2:319 RAWSON
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3825
Mailing Address - Country:US
Mailing Address - Phone:312-942-5932
Mailing Address - Fax:312-942-4990
Practice Address - Street 1:1750 W HARRISON ST
Practice Address - Street 2:319 RAWSON
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3825
Practice Address - Country:US
Practice Address - Phone:312-942-5932
Practice Address - Fax:312-942-4990
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0714236103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical