Provider Demographics
NPI:1801887369
Name:ORNOWSKI, WOJCIECH (MD)
Entity type:Individual
Prefix:DR
First Name:WOJCIECH
Middle Name:
Last Name:ORNOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16105 LASALLE ST.
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473
Mailing Address - Country:US
Mailing Address - Phone:708-566-4134
Mailing Address - Fax:708-713-4143
Practice Address - Street 1:16105 LASALLE ST.
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473
Practice Address - Country:US
Practice Address - Phone:708-566-4134
Practice Address - Fax:708-713-4143
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036094416207R00000X, 207RS0012X
IN01045993A207R00000X
IN01045993207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036094416Medicaid
IL036094416Medicaid
IL208519Medicare PIN
ILK04711Medicare UPIN