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NPI Code Detail

MEDICARE: DONALD VINCENT WOZNICA MD

MEDICARE: DONALD VINCENT WOZNICA MD
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 Physician036 059741IL

General Provider Information

NPI Number : 1467520809
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD VINCENT WOZNICA MD
Provider Business Mailing Address
First Line : 711 S ELMWOOD AVE
Second Line :
City : OAK PARK
State : IL
Zip : 60304-1414
Country : US
Telephone Number : 708-383-8619
Fax Number :
Provider Business Practice Location Address
First Line : 2355 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-3837
Country : US
Telephone Number : 773-254-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2006
Last Update Date : 07/08/2007

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