Provider Demographics
NPI:1033279435
Name:DIXIT, UNNATI S (OD)
Entity Type:Individual
Prefix:DR
First Name:UNNATI
Middle Name:S
Last Name:DIXIT
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 1:122 BROADVIEW VILLAGE SQ # 24
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60155-4874
Mailing Address - Country:US
Mailing Address - Phone:708-343-2099
Mailing Address - Fax:708-343-2081
Practice Address - Street 1:122 BROADVIEW VILLAGE SQ # 24
Practice Address - Street 2:
Practice Address - City:BROADVIEW
Practice Address - State:IL
Practice Address - Zip Code:60155-4874
Practice Address - Country:US
Practice Address - Phone:708-343-2099
Practice Address - Fax:708-343-2081
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL46009561152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILMD1045702OtherDEA