Provider Demographics
NPI:1063561058
Name:WOJCIK, NANCY A (OD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:WOJCIK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:A
Other - Last Name:ELMORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:211 NORTH TRL
Mailing Address - Street 2:
Mailing Address - City:HAWTHORN WOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60047-7718
Mailing Address - Country:US
Mailing Address - Phone:847-726-1218
Mailing Address - Fax:847-398-0084
Practice Address - Street 1:450 E RAND RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3101
Practice Address - Country:US
Practice Address - Phone:847-398-3303
Practice Address - Fax:847-398-4780
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT88660Medicare UPIN
ILL77828Medicare ID - Type Unspecified