Provider Demographics
NPI:1013365188
Name:GLEBIV, NATALIE WOZNY (OD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:WOZNY
Last Name:GLEBIV
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6013 N CICERO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-4301
Mailing Address - Country:US
Mailing Address - Phone:773-389-5409
Mailing Address - Fax:773-389-5405
Practice Address - Street 1:6013 N CICERO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4301
Practice Address - Country:US
Practice Address - Phone:773-389-5409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.011000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist