Provider Demographics
NPI:1790459758
Name:CELER, BARTLOMIEJ (OD)
Entity Type:Individual
Prefix:
First Name:BARTLOMIEJ
Middle Name:
Last Name:CELER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10103 ASHLEY ST
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-2347
Mailing Address - Country:US
Mailing Address - Phone:224-325-2186
Mailing Address - Fax:
Practice Address - Street 1:520 HARTBROOK DR
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-1405
Practice Address - Country:US
Practice Address - Phone:262-367-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-03
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3695152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist