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General NPI Number Information
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NPI Number | 1639530488
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Entity Type | Individual
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Provider Name | GRZEGORZ KRAWCZYK
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Gender | Male
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 5325 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60641-4104
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Country | US
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Telephone | 773-877-0016
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Fax |
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Provider Business Mailing Address
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Address Line | 2331 N SAYRE AVE APT 2D
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City | CHICAGO
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State | IL
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Zip | 60707-2944
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Country | US
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Telephone | (312) 927-9200
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Fax | 773-799-8325
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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 | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 070022020
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License Number State | IL
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