MEDICARE: RENEE WOJCIK MA, BCBA

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
1	106S00000X	Behavior Technician
2	171M00000X	Case Manager/Care Coordinator
3	390200000X	Student in an Organized Health Care Education/Training Program		OH
4	103K00000X	Behavior Analyst	1-21-48300	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063939783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE WOJCIK MA, BCBA

Provider Business Mailing Address
First Line	:	320 BEN CURTIS DR
Second Line	:
City	:	OSTRANDER
State	:	OH
Zip	:	43061-7505
Country	:	US
Telephone Number	:	847-207-5411
Fax Number	:

Provider Business Practice Location Address
First Line	:	733 HASTINGS DR
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-6906
Country	:	US
Telephone Number	:	847-207-5411
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2017
Last Update Date	:	03/31/2021

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