Organization
MAREK WALCZYK MD,SC
Active
Organization
MAREK WALCZYK MD,SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAREK WALCZYK MD (OWNER)
(708) 647-7550
Entity
Organization
Contact information
Practice address
1820 RIDGE RD, STE: 104, HOMEWOOD, IL 60430-1760
(708) 647-7550
(708) 647-7564
Mailing address
1820 RIDGE RD, STE 104, HOMEWOOD, IL 60430-1760
(708) 647-7550
(708) 647-7564
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
036107779
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036107779
—
IL
Enumeration date
04/24/2008
Last updated
04/24/2008
Update your record
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