Provider Demographics
NPI:1942265608
Name:BOJCHUK, JOHN (ATCL)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:BOJCHUK
Suffix:
Gender:M
Credentials:ATCL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 MEADOWLARK RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1329
Mailing Address - Country:US
Mailing Address - Phone:312-735-0257
Mailing Address - Fax:
Practice Address - Street 1:373 MEADOWLARK RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1329
Practice Address - Country:US
Practice Address - Phone:312-735-0257
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist