Healthcare Provider Details

I. General information

NPI: 1154740959
Provider Name (Legal Business Name): EWELINA WOJNAROWSKI MA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 05/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 DUNDEE RD SUITE 704
NORTHBROOK IL
60062-2437
US

IV. Provider business mailing address

3100 DUNDEE RD SUITE 704
NORTHBROOK IL
60062-2437
US

V. Phone/Fax

Practice location:
  • Phone: 847-498-5437
  • Fax:
Mailing address:
  • Phone: 847-498-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-13-13034
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: