Provider Demographics
NPI:1518018589
Name:SAWITZKE, MONICA J (OD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:J
Last Name:SAWITZKE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3582 W MEGAN ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-5924
Mailing Address - Country:US
Mailing Address - Phone:480-726-6827
Mailing Address - Fax:
Practice Address - Street 1:15725 SOUTH 46TH ST
Practice Address - Street 2:SUITE 112
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048
Practice Address - Country:US
Practice Address - Phone:480-893-2300
Practice Address - Fax:480-893-0522
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1135152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU99742Medicare UPIN