Dr. Michael Iwanicki
Surgeon Trauma Surgeon
3815 Highland Ave Tower 2, Suite 107
Downers Grove
, Illinois 60515-1500
Dr. Michael Iwanicki
Surgeon Trauma Surgeon
3815 Highland Ave Tower 2, Suite 107
Downers Grove
, Illinois 60515-1500
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About
Features
Specialties
- Surgeon
- Trauma Surgeon
Languages spoken
- English
Location
First Address
- Dr. Michael Iwanicki
- 561 Terrace Ln
- South Elgin, IL
- Zip : 60177-2254
- Phone :
Second Address
- Dr. Michael Iwanicki
- 3815 Highland Ave Tower 2, Suite 107
- Downers Grove, IL
- Zip : 60515-1500
- Fax : (630) 810-9240
- Phone : (630) 275-7800
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208200000X | Surgeon | 036-105399 | IL |
| Y | 208600000X | Surgeon | 036-105399 | IL |
| N | 2086S0127X | Trauma Surgeon | 036-105399 | IL |
National Provider Identifier
| NPI | 1003845561 |
|---|---|
| Provider Name | Dr. Michael Iwanicki |
| First Address | South Elgin, IL 60177-2254 |
| Second Address | Downers Grove, IL 60515-1500 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/06/2006 |
| Last Update Date | 21/12/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| H75064 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.