Organization
MAREK WALCZYK MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAREK WALCZYK MD (OWNER)
(708) 224-8840
Entity
Organization
Contact information
Practice address
1300 HIGGINS RD, 212, PARK RIDGE, IL 60068-5743
(847) 823-5151
Mailing address
1300 HIGGINS RD, 212, PARK RIDGE, IL 60068-5743
(847) 823-5151
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020363109
—
IL
01
—
1632658
BCBS
IL
Enumeration date
07/24/2008
Last updated
07/24/2008
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