Healthcare Provider Details

I. General information

NPI: 1114739208
Provider Name (Legal Business Name): OLYVIA GRYZIK OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 COMPASS RD
GLENVIEW IL
60026-8001
US

IV. Provider business mailing address

744 WESLEY DR
PARK RIDGE IL
60068-2147
US

V. Phone/Fax

Practice location:
  • Phone: 877-787-3430
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056.016343
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: