Provider Demographics
NPI:1740385434
Name:WOOD, JANICE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:MARIE
Last Name:WOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4962 ESSINGTON CT
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5525
Mailing Address - Country:US
Mailing Address - Phone:847-705-7919
Mailing Address - Fax:
Practice Address - Street 1:450 DUNDEE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-4205
Practice Address - Country:US
Practice Address - Phone:847-742-5920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine