Provider Demographics
NPI:1518916741
Name:WEXLER, STEVEN M (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:WEXLER
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 1:310 S GREENLEAF ST STE 209
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5708
Mailing Address - Country:US
Mailing Address - Phone:847-244-1657
Mailing Address - Fax:847-244-5122
Practice Address - Street 1:310 S GREENLEAF ST STE 209
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5708
Practice Address - Country:US
Practice Address - Phone:847-244-1657
Practice Address - Fax:847-244-5122
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-008667152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU63178Medicare UPIN
IL386980Medicare ID - Type Unspecified(INACTIVE) WILL ACTIVATE.