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NPI Code Detail

MEDICARE: DR. ROGER ALAN WUJEK M.D.

MEDICARE: DR. ROGER ALAN WUJEK M.D.
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
1207Q00000XFamily Medicine Physician36-54814IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1779330OTHERILMEDICARE GROUP
3080022054OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386635225
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER ALAN WUJEK M.D.
Provider Business Mailing Address
First Line : 1285 FRANCISCAN DR
Second Line :
City : LITCHFIELD
State : IL
Zip : 62056-1778
Country : US
Telephone Number : 217-324-1035
Fax Number : 217-324-3320
Provider Business Practice Location Address
First Line : 1285 FRANCISCAN DR
Second Line :
City : LITCHFIELD
State : IL
Zip : 62056-1778
Country : US
Telephone Number : 217-324-6127
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 02/08/2017

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