Provider Demographics
NPI:1366681017
Name:RICHARD E. WOJCIK, O.D.,P.C.
Entity Type:Organization
Organization Name:RICHARD E. WOJCIK, O.D.,P.C.
Other - Org Name:THE EYE DOC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:WOJCIK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:708-687-2500
Mailing Address - Street 1:14700 KOLMAR AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:IL
Mailing Address - Zip Code:60445-3276
Mailing Address - Country:US
Mailing Address - Phone:708-687-2500
Mailing Address - Fax:708-687-2504
Practice Address - Street 1:14700 KOLMAR AVE
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:IL
Practice Address - Zip Code:60445-3276
Practice Address - Country:US
Practice Address - Phone:708-687-2500
Practice Address - Fax:708-687-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046006792152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1861662934OtherNPI ROMEOVILLE CORP BY CMS
IL046006792Medicaid
1366681017OtherNPI MIDLOTHIAN CORP BY CMS
1629115951OtherNPI DR. WOJCIK PERSONAL BY CMS
046006792OtherIL. LISC.
046006792OtherIL. LISC.
IL0611780002Medicare NSC
MW0225943OtherDEA
IL657011Medicare PIN
ILIL1971Medicare PIN