Provider Demographics
NPI:1326371204
Name:KAWECKA, JOANNA M (OD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:M
Last Name:KAWECKA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E HIGGINS RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4701
Mailing Address - Country:US
Mailing Address - Phone:847-884-8799
Mailing Address - Fax:847-884-7577
Practice Address - Street 1:700 E HIGGINS RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4701
Practice Address - Country:US
Practice Address - Phone:847-884-8799
Practice Address - Fax:847-884-7577
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010239152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist