Provider Demographics
NPI:1326164377
Name:TODRYK, LAWRENCE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:TODRYK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 BELLE CT
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-2301
Mailing Address - Country:US
Mailing Address - Phone:224-577-5308
Mailing Address - Fax:
Practice Address - Street 1:100 N ATKINSON RD STE 106
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-7805
Practice Address - Country:US
Practice Address - Phone:224-577-5308
Practice Address - Fax:847-223-0911
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006449103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical