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NPI Code Detail

MEDICARE: EDGAR WOZNICA M.D.

MEDICARE: EDGAR WOZNICA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician036161573IL
22084P0800XPsychiatry Physician7294MD
32084P0802XAddiction Psychiatry Physician036.161573IL

General Provider Information

NPI Number : 1205221314
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDGAR WOZNICA M.D.
Provider Business Mailing Address
First Line : 676 N SAINT CLAIR ST STE 1100
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2954
Country : US
Telephone Number : 312-695-5060
Fax Number : 312-695-5010
Provider Business Practice Location Address
First Line : 676 N SAINT CLAIR ST STE 1100
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2954
Country : US
Telephone Number : 312-695-5060
Fax Number : 312-695-5010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2015
Last Update Date : 03/20/2025

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Directions to “ EDGAR WOZNICA M.D.” Practice Location

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