Provider Demographics
NPI:1104065291
Name:BRYNICZKA, ADAM WILLIAM (DPM)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:WILLIAM
Last Name:BRYNICZKA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:705 WARRENVILLE RD STE B
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-6379
Mailing Address - Country:US
Mailing Address - Phone:630-668-8277
Mailing Address - Fax:630-668-3358
Practice Address - Street 1:705 WARRENVILLE RD STE B
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-6379
Practice Address - Country:US
Practice Address - Phone:630-668-8277
Practice Address - Fax:630-668-3358
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-005396213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery