Provider Demographics
NPI:1396166690
Name:WOSZCZYNSKI, BLAZEJ (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BLAZEJ
Middle Name:
Last Name:WOSZCZYNSKI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1964 SPRINGBROOK SQUARE DR
Mailing Address - Street 2:108
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5949
Mailing Address - Country:US
Mailing Address - Phone:773-865-1080
Mailing Address - Fax:
Practice Address - Street 1:1964 SPRINGBROOK SQUARE DR
Practice Address - Street 2:108
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5949
Practice Address - Country:US
Practice Address - Phone:630-946-2565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-04
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.294988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist