Provider Demographics
NPI:1285690982
Name:CZARNECKI, WILLIAM ALAN (DPM)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALAN
Last Name:CZARNECKI
Suffix:
Gender:M
Credentials:DPM
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Other - Credentials:
Mailing Address - Street 1:2200 W HIGGINS RD
Mailing Address - Street 2:#230
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-2428
Mailing Address - Country:US
Mailing Address - Phone:847-884-8863
Mailing Address - Fax:847-884-8863
Practice Address - Street 1:2200 W HIGGINS RD
Practice Address - Street 2:SUBURBAN PODIATRY LTD #230
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60195-2428
Practice Address - Country:US
Practice Address - Phone:847-884-8863
Practice Address - Fax:847-884-8863
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016003995213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL60001600OtherBCBS
T39090Medicare UPIN
IL786750Medicare ID - Type Unspecified