Provider Demographics
NPI:1205951647
Name:GREENSPAN, STEVEN B (OD, PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:GREENSPAN
Suffix:
Gender:M
Credentials:OD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9150 CRAWFORD AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1700
Mailing Address - Country:US
Mailing Address - Phone:847-763-9760
Mailing Address - Fax:847-763-9762
Practice Address - Street 1:9150 CRAWFORD AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1700
Practice Address - Country:US
Practice Address - Phone:847-763-9760
Practice Address - Fax:847-763-9762
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
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