Provider Demographics
NPI:1215376165
Name:LENZ, KATHERINE (O D)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:LENZ
Suffix:
Gender:F
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 MAIN ST STE 125
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-3419
Mailing Address - Country:US
Mailing Address - Phone:847-726-2020
Mailing Address - Fax:
Practice Address - Street 1:950 W IL ROUTE 22
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-3417
Practice Address - Country:US
Practice Address - Phone:847-726-2020
Practice Address - Fax:847-726-2036
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010682152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist