Provider Demographics
NPI:1326294935
Name:WOLNIAK, KRISTY LUCILE (MD, PHD)
Entity Type:Individual
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First Name:KRISTY
Middle Name:LUCILE
Last Name:WOLNIAK
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Gender:F
Credentials:MD, PHD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:303 E CHICAGO AVE
Mailing Address - Street 2:W127 WARD 6-223, NORTHWESTERN UNIVERSITY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4296
Mailing Address - Country:US
Mailing Address - Phone:312-503-8144
Mailing Address - Fax:
Practice Address - Street 1:303 E CHICAGO AVE
Practice Address - Street 2:W127 WARD 6-223, NORTHWESTERN UNIVERSITY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4296
Practice Address - Country:US
Practice Address - Phone:312-503-8144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125050776207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology