Healthcare Provider Details

I. General information

NPI: 1013189091
Provider Name (Legal Business Name): LAWRENCE MICHAEL WOJCIK PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2008
Last Update Date: 03/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18053 DAVIDS LN
ORLAND PARK IL
60467-8435
US

IV. Provider business mailing address

18053 DAVIDS LN
ORLAND PARK IL
60467-8435
US

V. Phone/Fax

Practice location:
  • Phone: 708-479-9346
  • Fax:
Mailing address:
  • Phone: 708-479-9346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: