Provider Demographics
NPI:1427171339
Name:MAJCHROWSKI, BARBARA J (OD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:MAJCHROWSKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5729 W 35TH STREET
Mailing Address - Street 2:SUITE 1EAST
Mailing Address - City:CICERO
Mailing Address - State:IL
Mailing Address - Zip Code:60804
Mailing Address - Country:US
Mailing Address - Phone:708-863-5000
Mailing Address - Fax:708-863-3559
Practice Address - Street 1:5729 W 35TH STREET
Practice Address - Street 2:SUITE 1EAST
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804
Practice Address - Country:US
Practice Address - Phone:708-863-5000
Practice Address - Fax:708-863-3559
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046007934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001684543OtherBLUE CROSS BLUE SHIELD
IL046007934Medicaid
IL346.000969OtherSTATE CONTROLL LICENSE
IL346.000969OtherSTATE CONTROLL LICENSE