Healthcare Provider Details

I. General information

NPI: 1699614172
Provider Name (Legal Business Name): GREGG P. PROJANSKY LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 WAUKEGAN RD STE 175
BANNOCKBURN IL
60015-1541
US

IV. Provider business mailing address

259 BURR OAK AVE
DEERFIELD IL
60015-4718
US

V. Phone/Fax

Practice location:
  • Phone: 847-407-9254
  • Fax: 847-503-9081
Mailing address:
  • Phone: 847-407-9254
  • Fax: 847-503-9081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227013816
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: