Provider Demographics
NPI:1710184452
Name:ADAS, MAGDALENA A (OD)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:A
Last Name:ADAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MAGDALENA
Other - Middle Name:A
Other - Last Name:MIKULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:60 W ERIE ST
Mailing Address - Street 2:UNIT 1401
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-4191
Mailing Address - Country:US
Mailing Address - Phone:847-414-5999
Mailing Address - Fax:321-642-4445
Practice Address - Street 1:9450 SKOKIE BLVD
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1311
Practice Address - Country:US
Practice Address - Phone:847-677-7202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management