Individual
DR. JACEK GRELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1011 STATE ST, SUITE 140, LEMONT, IL 60439-4768
(630) 754-0141
Mailing address
10S570 GLENN DR, BURR RIDGE, IL 60527-6822
(708) 636-1601
(708) 636-1825
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-098225
IL
207R00000X
Internal Medicine Physician
Primary
036098225
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098225
—
IL
Enumeration date
02/15/2006
Last updated
06/04/2009
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