Marek Walczyk MD,SC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

036107779 Issued in IL

Legal business name

MAREK WALCZYK MD,SC

Practice address

1820 Ridge Rd
Ste: 104
Homewood, IL 60430-1760

Phone

(708) 647-7550

Fax

(708) 647-7564

NPI assigned

Apr 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Marek Walczyk, MD

Title

Owner

Phone

(708) 647-7550

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Omer Abid, MD

  • Public Health & General Preventive Medicine Physician
  • Homewood, IL
  • NPI 1174539464
  NPD (past)

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1679748222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 RIDGE RD",
            "address_2": "STE 104",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301760",
            "telephone_number": "708-647-7550",
            "fax_number": "708-647-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 RIDGE RD",
            "address_2": "STE: 104",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301760",
            "telephone_number": "708-647-7550",
            "fax_number": "708-647-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAREK WALCZYK MD,SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "WALCZYK",
        "authorized_official_first_name": "MAREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-647-7550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": "036107779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036107779",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nour Malak, D.N.
• Elizabeth Ryann Maloney
• Maxine Ann Mancino, LCPC
• Manor Care of Homewood Il, LLC
• Joe Roberson Mardis, LCPC
• Rashel Marrero, LSW
• Mars Optical Group Inc
• Frances Mathews
• Melissa Matthews
• Virgil Matthews

• Adult Mental Health Clinic/Center in Homewood, IL
• Providers in Homewood, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.