Provider Demographics
NPI:1700921756
Name:KART, ALISA (OD)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:KART
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8235 LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2623
Mailing Address - Country:US
Mailing Address - Phone:847-401-7124
Mailing Address - Fax:708-457-1085
Practice Address - Street 1:4259 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:NORRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60706-1212
Practice Address - Country:US
Practice Address - Phone:708-457-2292
Practice Address - Fax:708-457-1085
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
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