Provider Demographics
NPI:1760677066
Name:VELICK, MARNEE CYD (OD)
Entity Type:Individual
Prefix:DR
First Name:MARNEE
Middle Name:CYD
Last Name:VELICK
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 1:146 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-3665
Mailing Address - Country:US
Mailing Address - Phone:847-548-2770
Mailing Address - Fax:
Practice Address - Street 1:910 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-1719
Practice Address - Country:US
Practice Address - Phone:847-999-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046008939152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID8825444OtherMULTIPLAN
IL1636706OtherBCBS
IL7235044OtherAETNA
IL211019OtherMEDICARE GROUP
IL211019OtherMEDICARE GROUP