Provider Demographics
NPI:1942342886
Name:MEIFERT, MARITZA (OD)
Entity Type:Individual
Prefix:MRS
First Name:MARITZA
Middle Name:
Last Name:MEIFERT
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 1:3919 HIGHKNOB CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8247
Mailing Address - Country:US
Mailing Address - Phone:630-904-1053
Mailing Address - Fax:
Practice Address - Street 1:4 FOX VALLEY CTR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4187
Practice Address - Country:US
Practice Address - Phone:630-851-0305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist