Healthcare Provider Details

I. General information

NPI: 1720095821
Provider Name (Legal Business Name): CHRISTINE M. GRYGIEL MA, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 SPRING RD SUITE 215
OAK BROOK IL
60523-1320
US

IV. Provider business mailing address

427 GATESHEAD DR
NAPERVILLE IL
60565-3148
US

V. Phone/Fax

Practice location:
  • Phone: 630-680-2000
  • Fax: 630-357-0423
Mailing address:
  • Phone: 630-357-0119
  • Fax: 630-357-0423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: