SearchIllinois101YM0800X

Kendall Gross

NPI 1649120932 · on the registry since 2026

Practice

Address
3016 Grand Ave
Waukegan, IL 60085
Phone
(847) 313-1071
Organisation at this address
Nicasa - Bridge House
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
101YM0800X
101YM0800X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-01-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois