MEDICARE: DR. ELIZABETH LOUISE GRYS DDS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry		IL
2	1223P0300X	Periodontics		IL

General Provider Information

NPI Number	:	1023166212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH LOUISE GRYS DDS, MS

Provider Business Mailing Address
First Line	:	4406 MADISON AVE
Second Line	:
City	:	BROOKFIELD
State	:	IL
Zip	:	60513-2314
Country	:	US
Telephone Number	:	708-485-1152
Fax Number	:

Provider Business Practice Location Address
First Line	:	5430 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-1225
Country	:	US
Telephone Number	:	773-594-9444
Fax Number	:	773-594-9407

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2007
Last Update Date	:	09/11/2025

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