Provider Demographics
NPI:1437341047
Name:SZAFRANSKI, CARLY (OD)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:SZAFRANSKI
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 1:18234 HALSTED ST
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2508
Mailing Address - Country:US
Mailing Address - Phone:708-798-7711
Mailing Address - Fax:708-798-1349
Practice Address - Street 1:5501 W PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:COUNTRYSIDE
Practice Address - State:IL
Practice Address - Zip Code:60525-3591
Practice Address - Country:US
Practice Address - Phone:708-482-7744
Practice Address - Fax:708-482-8838
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.009975152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist