Provider Demographics
NPI:1568569614
Name:SZEWCZYK, SYLWIA DOMINIKA (OD)
Entity Type:Individual
Prefix:DR
First Name:SYLWIA
Middle Name:DOMINIKA
Last Name:SZEWCZYK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 S PRAIRIE AVE
Mailing Address - Street 2:APT 1805
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3652
Mailing Address - Country:US
Mailing Address - Phone:773-774-2200
Mailing Address - Fax:773-774-2211
Practice Address - Street 1:5526 N MILWAUKEE AVE UNIT B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-1227
Practice Address - Country:US
Practice Address - Phone:773-774-2200
Practice Address - Fax:773-774-2211
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.009890152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK31754Medicare PIN
ILK31754Medicare UPIN