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NPI Code Detail

MEDICARE: DEXTER RAY GRZYB

MEDICARE: DEXTER RAY GRZYB
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystBACB1468407IL

General Provider Information

NPI Number : 1013842608
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEXTER RAY GRZYB
Provider Business Mailing Address
First Line : 6500 N LINCOLN AVE
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-3923
Country : US
Telephone Number : 630-465-3963
Fax Number :
Provider Business Practice Location Address
First Line : 6500 N LINCOLN AVE
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-3923
Country : US
Telephone Number : 630-465-3963
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “ DEXTER RAY GRZYB ” Practice Location

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