Provider Demographics
NPI:1265009419
Name:LAUREN WOJCIK MCNICHOLAS, O.D., P.C.
Entity Type:Organization
Organization Name:LAUREN WOJCIK MCNICHOLAS, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:WOJCIK
Authorized Official - Last Name:MCNICHOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:815-823-7628
Mailing Address - Street 1:330 SPANGLER RD
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-1840
Mailing Address - Country:US
Mailing Address - Phone:815-886-0800
Mailing Address - Fax:
Practice Address - Street 1:330 SPANGLER RD
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446
Practice Address - Country:US
Practice Address - Phone:815-886-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty