Angela Gryzbek, M.S.N.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209012740 Issued in IL

Practice address

4405 Weaver Pkwy
Warrenville, IL 60555-3269

Phone

(630) 933-7811

NPI assigned

Apr 14, 2015

Last updated

Mar 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Angela Bradford Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1144616327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1058 BRISTOL CT",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601898723",
            "telephone_number": "630-933-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 WEAVER PKWY",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553269",
            "telephone_number": "630-933-7811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4455 Weaver Pkwy",
            "address_purpose": "LOCATION",
            "city": "Warrenville",
            "state": "IL",
            "postal_code": "605553269",
            "country_code": "US",
            "telephone_number": "877-887-5807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRYZBEK",
        "first_name": "ANGELA",
        "credential": "M.S.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-14",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209012740",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041354730",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abradford76724@direct.luhs.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2160 S 1st Ave",
            "address_2": "Bldg 105 Rm 2944",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "BRADFORD",
            "credential": "M.S.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nurse Practitioner in Warrenville, IL
• Providers in Warrenville, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.