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NPI Code Detail

MEDICARE: KONRAD GRZESZKOWIAK D.C.

MEDICARE: KONRAD GRZESZKOWIAK D.C.
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
1111N00000XChiropractor038012577IL

General Provider Information

NPI Number : 1740602234
Entity Type Code : Individual
Provider Name (Legal Business Name) : KONRAD GRZESZKOWIAK D.C.
Provider Business Mailing Address
First Line : 10354 PARKSIDE AVE
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-4562
Country : US
Telephone Number : 847-207-2407
Fax Number :
Provider Business Practice Location Address
First Line : 1249 WAUKEGAN RD
Second Line :
City : GLENVIEW
State : IL
Zip : 60025-3077
Country : US
Telephone Number : 847-486-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2014
Last Update Date : 01/17/2014

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Directions to “ KONRAD GRZESZKOWIAK D.C.” Practice Location

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