Provider Demographics
NPI:1013117043
Name:HERTZBERG, KATHERINE HELEN (OD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:HELEN
Last Name:HERTZBERG
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 1:29 S WEBSTER ST STE 104
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5353
Mailing Address - Country:US
Mailing Address - Phone:630-357-6880
Mailing Address - Fax:630-357-6995
Practice Address - Street 1:29 S WEBSTER ST STE 104
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5353
Practice Address - Country:US
Practice Address - Phone:630-357-6880
Practice Address - Fax:630-357-6880
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010006152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist