Provider Demographics
NPI:1295877132
Name:WOJCIAK, MICHAEL J (OD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:WOJCIAK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:7513 BAIMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-4453
Mailing Address - Country:US
Mailing Address - Phone:630-241-1937
Mailing Address - Fax:
Practice Address - Street 1:3 WOODFIELD MALL
Practice Address - Street 2:JCPENNEY OPTICAL
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5012
Practice Address - Country:US
Practice Address - Phone:847-240-5655
Practice Address - Fax:847-240-5156
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.007953152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist