Provider Demographics
NPI:1801990007
Name:LANGIEWICZ, JANUSZ (MDPHD)
Entity type:Individual
Prefix:DR
First Name:JANUSZ
Middle Name:
Last Name:LANGIEWICZ
Suffix:
Gender:M
Credentials:MDPHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EXECUTIVE CENTER STE 3
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010
Mailing Address - Country:US
Mailing Address - Phone:847-304-6999
Mailing Address - Fax:847-304-6888
Practice Address - Street 1:1 EXECUTIVE CENTER STE 3
Practice Address - Street 2:
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010
Practice Address - Country:US
Practice Address - Phone:847-304-6999
Practice Address - Fax:847-304-6888
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036075029207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036075029Medicaid
IL209062Medicare PIN
IL036075029Medicaid