Individual provider Active NPI

Gregory C. Bryniczka, DPM

  • Podiatrist
  • Wheaton, IL
National Provider Identifier
1174522379
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
162778 Issued in IL
Practice address
705 Warrenville Rd
Unit B
Wheaton, IL 60189-6379
Phone
(630) 668-8277
Fax
(630) 668-3358
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 162778 IL Primary

Addresses

Primary practice location

705 Warrenville Rd
Unit B
Wheaton, IL 60189-6379

Mailing address

705 Warrenville Rd
Unit B
Wheaton, IL 60189-6379
Phone (630) 668-8277

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621001157 IL Practitioner - Podiatry 8729988639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Podiatry CenterGroup PAC ID 0749180636, 6 clinicians

Practice addresses (Care Compare)

2124 Ogden Ave
Suite 101
Aurora, IL 60504-7542
Phone (630) 585-8087

234 Randall Rd
South Elgin, IL 60177-2274
Phone (847) 608-9494

31 S Sutton Rd
Streamwood, IL 60107-3367
Phone (630) 830-2155

705 Warrenville Rd
Suite B
Wheaton, IL 60189-6379
Phone (630) 668-8277

705 Warrenville Rd B
Wheaton, IL 60189-6379

7954 W Oakton St
Niles, IL 60714-2457
Phone (847) 823-5510

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue166
Removal of skin lesions32
Removal of nail tissue147
Removal or shaving of skin growth41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
162778ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Podiatry Center CurrentSince Mar 16, 2004 Accepting new patients
Northwest Podiatry Center CurrentSince Jan 1, 1979 Accepting new patients

Locations

2124 Ogden Ave
Ste 101
Aurora, IL 60504
Phone (630) 585-8087

3254 Sycamore Rd
DeKalb, IL 60115
Phone (815) 756-9491

13312 Village Green Dr
Huntley, IL 60142
Phone (847) 515-2030

7954 W Oakton St
Niles, IL 60714
Phone (708) 823-5510

234 Randall Rd
South Elgin, IL 60177
Phone (847) 608-9494

31 S Sutton Rd
Streamwood, IL 60107
Phone (630) 830-2155

705 Warrenville Rd
Ste B
Wheaton, IL 60189
Phone (630) 668-8277

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1174522379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WARRENVILLE RD",
            "address_2": "UNIT B",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601896379",
            "telephone_number": "630-668-8277",
            "fax_number": "630-668-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 WARRENVILLE RD",
            "address_2": "UNIT B",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601896379",
            "telephone_number": "630-668-8277",
            "fax_number": "630-668-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYNICZKA",
        "first_name": "GREGORY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "162778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.