Wiacek, Jan

Wiacek, Jan is an individual health care provider with primary practice located at 3204 N Oak Park Ave , Chicago IL 60634-4640. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wiacek, Jan can be contacted via phone (773) 736-3131.

Contact Information

Primary practice address
3204 N Oak Park Ave Chicago IL 60634-4640
Phone: (773) 736-3131
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036088918 Illinois

Profile Details

NPI number 1548263130
LBN Legal business name Wiacek, Jan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Oct 23rd, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548263130 NPPES
Illinois MEDICAID 036088918

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