Provider Demographics
NPI:1861662934
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:OPTOMETRIST/OWNER
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:815-886-0800
Mailing Address - Street 1:330 SPANGLER RD
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-1840
Mailing Address - Country:US
Mailing Address - Phone:815-886-0800
Mailing Address - Fax:815-886-4493
Practice Address - Street 1:330 SPANGLER RD
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-1840
Practice Address - Country:US
Practice Address - Phone:815-886-0800
Practice Address - Fax:815-886-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2021-01-29
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
IL046006792Medicaid
0611780002OtherDMERC MIDLOTHIAN
1366681017OtherMIDLOTHIAN NPI
ILIL1970OtherCMS PTAN
046-006792OtherILL.LISCENSE
IL0611780001Medicare NSC
ILIL1970Medicare PIN
IL657011Medicare PIN
046-006792OtherILL.LISCENSE
ILT37529Medicare UPIN