Provider Demographics
NPI:1265786925
Name:VERONICA M RALICK OD & ASSOCIATES
Entity type:Organization
Organization Name:VERONICA M RALICK OD & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RALICK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:773-750-5222
Mailing Address - Street 1:7359 WINCHESTER LN
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-1776
Mailing Address - Country:US
Mailing Address - Phone:219-322-5205
Mailing Address - Fax:219-322-5233
Practice Address - Street 1:1525 US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1353
Practice Address - Country:US
Practice Address - Phone:219-322-5205
Practice Address - Fax:219-322-5233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-02
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003290A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty