Provider Demographics
NPI:1881815025
Name:OLSON, KAREN (OD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:OLSON
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 1:1669 FAIRPORT DR
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-7946
Mailing Address - Country:US
Mailing Address - Phone:847-309-0098
Mailing Address - Fax:847-358-4970
Practice Address - Street 1:279 N NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-5326
Practice Address - Country:US
Practice Address - Phone:847-358-4970
Practice Address - Fax:847-358-4972
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0046-009046152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist