Provider Demographics
NPI:1518581123
Name:CHECKISAURUS LLC
Entity Type:Organization
Organization Name:CHECKISAURUS LLC
Other - Org Name:MONA HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:PACZKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-709-2980
Mailing Address - Street 1:44648 MOUND RD # 155
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1322
Mailing Address - Country:US
Mailing Address - Phone:248-709-2980
Mailing Address - Fax:
Practice Address - Street 1:11375 DELVIN DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-2606
Practice Address - Country:US
Practice Address - Phone:248-709-2980
Practice Address - Fax:734-655-9034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-31
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty