Provider Demographics
NPI:1881208205
Name:GREBSKA-COMPTON, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:GREBSKA-COMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 MARIGOLD PL
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60433-2119
Mailing Address - Country:US
Mailing Address - Phone:312-505-0906
Mailing Address - Fax:
Practice Address - Street 1:307 MARIGOLD PL
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60433-2119
Practice Address - Country:US
Practice Address - Phone:312-505-0906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227006660225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist