Healthcare Provider Details

I. General information

NPI: 1063561058
Provider Name (Legal Business Name): NANCY A WOJCIK O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY A ELMORE

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E RAND RD
ARLINGTON HEIGHTS IL
60004-3101
US

IV. Provider business mailing address

211 NORTH TRL
HAWTHORN WOODS IL
60047-7718
US

V. Phone/Fax

Practice location:
  • Phone: 847-398-3303
  • Fax: 847-398-4780
Mailing address:
  • Phone: 847-726-1218
  • Fax: 847-398-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: