# GREGORY KACZMAREK, MD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780925305
- **Authorized official:** DR. GREGORY D KACZMAREK M.D. (PRESIDENT)
- **Authorized official phone:** (847) 679-6707

## Contact information

- **Practice address:** 4905 OLD ORCHARD CTR, LOWER LEVEL, SKOKIE, IL 60077-1458
- **Practice address phone:** (847) 679-6707
- **Mailing address:** 4905 OLD ORCHARD CTR, LOWER LEVEL, SKOKIE, IL 60077-1458
- **Mailing address phone:** (847) 679-6707

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 036081697 | IL | Yes |

## Other

- **Enumeration date:** 03/06/2013
- **Last updated:** 03/06/2013