Healthcare Provider Details

I. General information

NPI: 1083350508
Provider Name (Legal Business Name): CHRISTOPHER P WOJCIK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2022
Last Update Date: 07/20/2024
Certification Date: 07/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 W WELLINGTON AVE RM 1312
CHICAGO IL
60657-5147
US

IV. Provider business mailing address

4423 N ASHLAND AVE APT 105
CHICAGO IL
60640-5909
US

V. Phone/Fax

Practice location:
  • Phone: 773-975-1600
  • Fax:
Mailing address:
  • Phone: 815-342-9472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTL.0009184
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number125084965
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberTL.0009184
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: