Provider Demographics
NPI:1720095821
Name:GRYGIEL, CHRISTINE M (MA, LCPC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:GRYGIEL
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 GATESHEAD DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-3148
Mailing Address - Country:US
Mailing Address - Phone:630-357-0119
Mailing Address - Fax:630-357-0423
Practice Address - Street 1:1550 SPRING RD
Practice Address - Street 2:SUITE 215
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1320
Practice Address - Country:US
Practice Address - Phone:630-680-2000
Practice Address - Fax:630-357-0423
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232592Medicare UPIN