Individual
BOZENA EWA SCIGACZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
28 W LAKE ST, SUITE # 2, ADDISON, IL 60101-2709
(630) 458-0688
(630) 458-0698
Mailing address
28 W LAKE ST, SUITE # 2, ADDISON, IL 60101-2709
(630) 458-0688
(630) 458-0698
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036107066
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213586
MEDICARE GROUP PTAN
IL
01
—
K27755
MEDICARE PTAN
IL
01
—
P00313447
RAILROAD MEDICARE
IL
Enumeration date
05/20/2006
Last updated
12/22/2021
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