Provider Demographics
NPI:1679854160
Name:SETORK, SHEILA M (OD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:M
Last Name:SETORK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5301 TOUHY AVE
Mailing Address - Street 2:# 1
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3247
Mailing Address - Country:US
Mailing Address - Phone:847-983-8777
Mailing Address - Fax:
Practice Address - Street 1:5301 TOUHY AVE
Practice Address - Street 2:# 1
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3247
Practice Address - Country:US
Practice Address - Phone:847-983-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010510152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist