Provider Demographics
NPI:1750303277
Name:WOLODKO, MARGARET A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:A
Last Name:WOLODKO
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 1:116 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-4217
Mailing Address - Country:US
Mailing Address - Phone:847-696-9200
Mailing Address - Fax:847-696-9206
Practice Address - Street 1:116 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4217
Practice Address - Country:US
Practice Address - Phone:847-696-9200
Practice Address - Fax:847-696-9206
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036109788207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036109788OtherLICENCE NUMBER
ILI01885Medicare UPIN