Provider Demographics
NPI:1851876593
Name:KALENYK, GRACE MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:MARIE
Last Name:KALENYK
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:MARIE
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2650 RIDGE AVE STE 1223
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:303 W LAKE ST
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2586
Practice Address - Country:US
Practice Address - Phone:630-527-3645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant