Provider Demographics
NPI:1669015723
Name:GEORGE RIBARCHIK OD PC
Entity Type:Organization
Organization Name:GEORGE RIBARCHIK OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIBARCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:815-206-0998
Mailing Address - Street 1:620 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-3216
Mailing Address - Country:US
Mailing Address - Phone:815-206-0998
Mailing Address - Fax:
Practice Address - Street 1:1275 LAKE AVE
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-7415
Practice Address - Country:US
Practice Address - Phone:815-206-0998
Practice Address - Fax:815-206-3090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty