Individual
DR. MICHAEL J IWANICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3815 HIGHLAND AVE, TOWER 2, SUITE 107, DOWNERS GROVE, IL 60515-1500
(630) 275-7800
(630) 810-9240
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036-105399
IL
2086S0127X
Trauma Surgery Physician
036-105399
IL
Other
Enumeration date
06/30/2006
Last updated
03/25/2025
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