Individual
GREGORY P WITKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27650 FERRY RD, SUITE 100, WARRENVILLE, IL 60555-3845
(630) 225-2663
(630) 225-2399
Mailing address
27650 FERRY RD, SUITE 100, WARRENVILLE, IL 60555-3845
(630) 225-2663
(630) 225-2399
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036123834
IL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
036-123834
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123834
—
IL
01
—
206147
MEDICARE GROUP
IL
01
—
206147133
MEDICARE INDIVIDUAL
IL
01
—
P01179010
RR MEDICARE
IL
Enumeration date
05/17/2007
Last updated
02/19/2018
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