Provider Demographics
NPI:1780605899
Name:PIEKOS, GRAZYNA (MD)
Entity type:Individual
Prefix:DR
First Name:GRAZYNA
Middle Name:
Last Name:PIEKOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 ESSINGTON RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-4912
Mailing Address - Country:US
Mailing Address - Phone:815-730-1200
Mailing Address - Fax:815-730-1066
Practice Address - Street 1:1513 ESSINGTON RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-4912
Practice Address - Country:US
Practice Address - Phone:815-730-1200
Practice Address - Fax:815-730-1066
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360902422084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036090242Medicaid
IL130016591OtherRAILROAD MEDICARE
IL130016591OtherRAILROAD MEDICARE
ILBP4981999OtherDEA
IL036090242Medicaid