Andrzej Wojewoda Podiatry PC
Organization Active NPI Podiatrist · Niles, IL
NPI 1679665376 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1679665376
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatrist 213E00000X
- Legal business name
- ANDRZEJ WOJEWODA PODIATRY PC
- Practice address
- 7042 N Milwaukee Ave
Niles, IL 60714-4423 - Phone
- (847) 609-1335
- NPI assigned
- Sep 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Andrzej Wojewoda, DPM
- Title
- President
- Phone
- (847) 609-1335
Practitioners 1
-
Andrzej Wojewoda, D.P.M
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060215000466 | IL | Part B Supplier - Clinic/Group Practice | 7315952181 |
Receives reassigned benefits from 1 practitioner Practice locations: Chicago, IL; Niles, IL |
| O20170130003130 | IL | DME Supplier - Physician - Podiatry | 7315952181 | Practice locations: Niles, IL |
National Provider Directory
Locations
7507 N Milwaukee Ave
Niles, IL 60714
Phone (847) 609-1335
7042 N Milwaukee Ave
Niles, IL 60714
Phone (773) 761-8342
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist |
213E00000X | IL | Yes |
Addresses
Primary practice location
7042 N Milwaukee Ave
Niles, IL 60714-4423
Mailing address
8044 W Cedar LN
Niles, IL 60714-2701
Phone (847) 609-1335
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7720673 | Other | IL | AETNA |
| 1634768 | Other | IL | BCBS |
Other providers in Niles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.