Healthcare Provider Details

I. General information

NPI: 1629925557
Provider Name (Legal Business Name): CINDI ANN GRIGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 MOON LAKE BLVD STE 140
HOFFMAN ESTATES IL
60169-1070
US

IV. Provider business mailing address

105 MEADOWDALE CT APT 107
CARPENTERSVILLE IL
60110-2022
US

V. Phone/Fax

Practice location:
  • Phone: 312-965-2997
  • Fax:
Mailing address:
  • Phone: 630-433-8879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: