Provider Demographics
NPI:1669024832
Name:SIMON PALAPARTHI, DEBBIE LISA (OD)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:LISA
Last Name:SIMON PALAPARTHI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:LISA
Other - Last Name:SIMON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:5822 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-3338
Mailing Address - Country:US
Mailing Address - Phone:516-776-5458
Mailing Address - Fax:
Practice Address - Street 1:709 S SEELEY ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-5554
Practice Address - Country:US
Practice Address - Phone:312-262-5725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009017152W00000X
IL046011722152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist