Provider Demographics
NPI:1053448118
Name:LOOK SHARP EYE CARE SPECIALISTS LTD
Entity Type:Organization
Organization Name:LOOK SHARP EYE CARE SPECIALISTS LTD
Other - Org Name:ELIZABETH G. DZIUBA, OD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:G
Authorized Official - Last Name:DZIUBA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-422-1413
Mailing Address - Street 1:373 N WOOD DALE RD
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191-1531
Mailing Address - Country:US
Mailing Address - Phone:630-422-1413
Mailing Address - Fax:630-422-1454
Practice Address - Street 1:373 N WOOD DALE RD
Practice Address - Street 2:
Practice Address - City:WOOD DALE
Practice Address - State:IL
Practice Address - Zip Code:60191-1531
Practice Address - Country:US
Practice Address - Phone:630-422-1413
Practice Address - Fax:630-422-1454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046008878152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046008878OtherSTATE LICENSE
IL214874Medicare PIN
ILU59282Medicare UPIN