Individual provider Active NPI

Wieslaw J Wojnarski, M.D.

  • Internal Medicine Physician
  • Glenview, IL
National Provider Identifier
1366504649
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036072075 Issued in IL
Practice address
3609 Lawson Rd
Glenview, IL 60026-1105
Phone
(847) 559-0596
Fax
(847) 559-0596
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036072075 IL Primary

Addresses

Primary practice location

3609 Lawson Rd
Glenview, IL 60026-1105

Mailing address

3609 Lawson Rd
Glenview, IL 60026-1105
Phone (847) 559-0596

Other identifiers 2

IdentifierTypeStateIssuer
31622517OtherILBLUE CROSS OF ILLINOIS
36072075MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080716000530 IL Practitioner - Internal Medicine 1557434032 Practice locations: Glenview, IL

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3609 Lawson Rd
Glenview, IL 60026-1105
Phone (847) 559-0596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1366504649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 LAWSON RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261105",
            "telephone_number": "847-559-0596",
            "fax_number": "847-559-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 LAWSON RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261105",
            "telephone_number": "847-559-0596",
            "fax_number": "847-559-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOJNARSKI",
        "first_name": "WIESLAW",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036072075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ILLINOIS",
            "identifier": "31622517",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36072075",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.