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General NPI Number Information
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NPI Number | 1144616327
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Entity Type | Individual
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Provider Name | ANGELA GRYZBEK M.S.N.
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Gender | Female
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 4405 WEAVER PKWY
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City | WARRENVILLE
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State | IL
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Zip | 60555-3269
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Country | US
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Telephone | 630-933-7811
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Fax |
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Provider Business Mailing Address
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Address Line | 1058 BRISTOL CT
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City | WHEATON
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State | IL
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Zip | 60189-8723
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Country | US
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Telephone | 630-933-7811
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041354730
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209012740
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License Number State | IL
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