Healthcare Provider Details

I. General information

NPI: 1629190426
Provider Name (Legal Business Name): GRZEGORZ BIGAJ DN, LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 N. MILWAUKEE AVE., SUITE # 2-29
NILES IL
60714-3159
US

IV. Provider business mailing address

7900 N. MILWAUKEE AVE., SUITE # 2-29
NILES IL
60714-3159
US

V. Phone/Fax

Practice location:
  • Phone: 773-879-7401
  • Fax:
Mailing address:
  • Phone: 773-879-7401
  • Fax: 224-531-7837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198001505
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number181000300
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: