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General NPI Number Information
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NPI Number | 1992797120
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Entity Type | Individual
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Provider Name | VYTENIS T GRYBAUSKAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 7350 W COLLEGE DR STE 208
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1189
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Country | US
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Telephone | 708-361-9199
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Fax | 708-361-9299
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Provider Business Mailing Address
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Address Line | 7350 W COLLEGE DR STE 208
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1189
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Country | US
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Telephone | 708-361-9199
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Fax | 708-361-9299
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 036061531
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License Number State | IL
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