Provider Demographics
NPI:1710512488
Name:GLASSES ON OAK ST
Entity Type:Organization
Organization Name:GLASSES ON OAK ST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SZAFRANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:312-751-0073
Mailing Address - Street 1:900 N MICHIGAN AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-1542
Mailing Address - Country:US
Mailing Address - Phone:312-751-0073
Mailing Address - Fax:312-751-0129
Practice Address - Street 1:900 N MICHIGAN AVE FL 5
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1542
Practice Address - Country:US
Practice Address - Phone:312-751-0073
Practice Address - Fax:312-751-0129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier