Provider Demographics
NPI:1477664035
Name:GUZIK, STEVEN P (OD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:P
Last Name:GUZIK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10339 W LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-1280
Mailing Address - Country:US
Mailing Address - Phone:815-469-7240
Mailing Address - Fax:815-469-7250
Practice Address - Street 1:10339 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1280
Practice Address - Country:US
Practice Address - Phone:815-469-7240
Practice Address - Fax:815-469-7250
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-009108152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212298OtherMEDICARE GROUP NUMBER
ILU77876Medicare UPIN
ILK20940Medicare ID - Type UnspecifiedMEDICARE NUMBER