Provider Demographics
NPI:1265737431
Name:STEVEN K. KAJITA O.D. P.C.
Entity type:Organization
Organization Name:STEVEN K. KAJITA O.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:KAJITA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-549-1516
Mailing Address - Street 1:2525 N LINCOLN AVE
Mailing Address - Street 2:SUITE D1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-7783
Mailing Address - Country:US
Mailing Address - Phone:773-549-1516
Mailing Address - Fax:773-549-8928
Practice Address - Street 1:2525 N LINCOLN AVE
Practice Address - Street 2:SUITE D1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-7783
Practice Address - Country:US
Practice Address - Phone:773-549-1516
Practice Address - Fax:773-549-8928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046008064332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier