Provider Demographics
NPI:1467766436
Name:ZEIFERT, CHRISTINE MARTINSON (OD)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:MARTINSON
Last Name:ZEIFERT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:LYNN
Other - Last Name:MARTINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1849 GREEN BAY RD
Mailing Address - Street 2:STE 165
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035
Mailing Address - Country:US
Mailing Address - Phone:847-497-2020
Mailing Address - Fax:847-497-2002
Practice Address - Street 1:1849 GREEN BAY RD
Practice Address - Street 2:STE 165
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035
Practice Address - Country:US
Practice Address - Phone:847-497-2020
Practice Address - Fax:847-497-2002
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010328152W00000X
IL046-010328152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL2998003Medicare PIN