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General NPI Number Information
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NPI Number | 1023166212
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Entity Type | Individual
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Provider Name | ELIZABETH LOUISE GRYS DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 01/06/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5430 N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60630-1225
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Country | US
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Telephone | 773-594-9444
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Fax | 773-594-9407
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Provider Business Mailing Address
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Address Line | 4406 MADISON AVE
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City | BROOKFIELD
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State | IL
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Zip | 60513-2314
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Country | US
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Telephone | 708-485-1152
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State | IL
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