Provider Demographics
NPI:1073626222
Name:LIEBERMAN, NATALIE (OD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:LIEBERMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:185 MILWAUKEE AVE
Mailing Address - Street 2:SUITE 135
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-3010
Mailing Address - Country:US
Mailing Address - Phone:847-325-4440
Mailing Address - Fax:
Practice Address - Street 1:185 MILWAUKEE AVE
Practice Address - Street 2:SUITE 135
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-3010
Practice Address - Country:US
Practice Address - Phone:847-325-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046008166152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL8825444OtherMULTIPLAN
IL046008166Medicaid
1636706OtherBCBS
7235044OtherAETNA
K41392OtherMEDICARE
210209OtherMEDICARE GROUP
1636706OtherBCBS
210209OtherMEDICARE GROUP