Provider Demographics
NPI:1295091403
Name:MACHNICA, KAROLINA WOLOSZYN
Entity type:Individual
Prefix:
First Name:KAROLINA
Middle Name:WOLOSZYN
Last Name:MACHNICA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 WAUKEGAN RD STE 140
Mailing Address - Street 2:
Mailing Address - City:BANNOCKBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60015-1868
Mailing Address - Country:US
Mailing Address - Phone:847-663-8540
Mailing Address - Fax:
Practice Address - Street 1:2151 WAUKEGAN RD STE 140
Practice Address - Street 2:
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1868
Practice Address - Country:US
Practice Address - Phone:847-444-1830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036143084207RE0101X
WAOP60577201207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty