Provider Demographics
NPI:1649778994
Name:GRYZBEK THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:GRYZBEK THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRYZBEK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:630-474-1171
Mailing Address - Street 1:1979 N MILL ST STE 204
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8472
Mailing Address - Country:US
Mailing Address - Phone:630-474-1171
Mailing Address - Fax:833-218-8811
Practice Address - Street 1:1979 N MILL ST STE 204
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8472
Practice Address - Country:US
Practice Address - Phone:630-474-1171
Practice Address - Fax:833-218-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009076261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health