St. Margaret Mercy Healthcare Centers Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ST. MARGARET MERCY HEALTHCARE CENTERS INC

Doing business as

Lynwood Family Services

Practice address

19400 North Creek Drive
Lynwood, IL 60411-8742

Phone

(708) 474-0410

Fax

(708) 474-0328

NPI assigned

Jul 10, 2008

Organization subpart

No

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

Authorized official

Name

Thomas Gryzbek

Title

President

Phone

(219) 932-2300

Specialties & licenses 1

Addresses

Other names 1

• Lynwood Family Services Doing business as

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1609030469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463110800",
            "telephone_number": "219-864-2107",
            "fax_number": "219-864-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19400 NORTH CREEK DRIVE",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604118742",
            "telephone_number": "708-474-0410",
            "fax_number": "708-474-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARGARET MERCY HEALTHCARE CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-10",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "GRYZBEK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-932-2300"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lynwood Family Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Lynwood, IL
• Providers in Lynwood, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.