Basic Information
| Provider Information | |||||||||
| NPI: | 1922410927 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WOZNICZKA | ||||||||
| FirstName: | DANIEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2650 RIDGE AVE RM 1223 | ||||||||
| Address2: | |||||||||
| City: | EVANSTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 602011700 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2650 RIDGE AVE RM 1223 | ||||||||
| Address2: | |||||||||
| City: | EVANSTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 602011700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475702040 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2014 | ||||||||
| LastUpdateDate: | 07/31/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 84906 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 036143743 | IL | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 84906 | GA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.