MEDICARE: GRZEGORZ KRAWCZYK

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	172M00000X	Mechanotherapist	070022020	IL

General Provider Information

NPI Number	:	1639530488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRZEGORZ KRAWCZYK

Provider Business Mailing Address
First Line	:	2331 N SAYRE AVE APT 2D
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60707-2944
Country	:	US
Telephone Number	:	(312) 927-9200
Fax Number	:	773-799-8325

Provider Business Practice Location Address
First Line	:	5325 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-4104
Country	:	US
Telephone Number	:	773-877-0016
Fax Number	:

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

Provider Enumeration Date	:	03/08/2016
Last Update Date	:	06/16/2018

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Directions to “ GRZEGORZ KRAWCZYK ” Practice Location

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