Provider Demographics
NPI:1538245964
Name:MARECIK, SLAWOMIR (MD)
Entity type:Individual
Prefix:
First Name:SLAWOMIR
Middle Name:
Last Name:MARECIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 N NORTHWEST HWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1411
Mailing Address - Country:US
Mailing Address - Phone:847-759-1110
Mailing Address - Fax:
Practice Address - Street 1:1550 N NORTHWEST HWY
Practice Address - Street 2:SUITE 107
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1411
Practice Address - Country:US
Practice Address - Phone:847-759-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036109520174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist