Provider Demographics
NPI:1760644090
Name:WOLOWICK, KAREN E (DO)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:WOLOWICK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:E
Other - Last Name:KOMSISKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1319 BUTTERFIELD RD STE 506
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-5601
Mailing Address - Country:US
Mailing Address - Phone:630-320-6703
Mailing Address - Fax:630-389-8863
Practice Address - Street 1:1319 BUTTERFIELD RD STE 506
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5601
Practice Address - Country:US
Practice Address - Phone:630-320-6703
Practice Address - Fax:630-389-8863
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036121269207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036121269Medicaid
ILP00631935OtherRR MEDICARE