Provider Demographics
NPI:1538482344
Name:POLO OPTYKA INC
Entity Type:Organization
Organization Name:POLO OPTYKA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONIKOWSKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-278-7191
Mailing Address - Street 1:3021 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6612
Mailing Address - Country:US
Mailing Address - Phone:773-278-7191
Mailing Address - Fax:773-278-7192
Practice Address - Street 1:3021 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6612
Practice Address - Country:US
Practice Address - Phone:773-278-7191
Practice Address - Fax:773-278-7192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty