Provider Demographics
NPI:1811169212
Name:MARY SZATKOWSKI-PRITIKIN, M.D.
Entity type:Organization
Organization Name:MARY SZATKOWSKI-PRITIKIN, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SZATKOWSKI-PRITIKIN, M.D.
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-332-4296
Mailing Address - Street 1:111 N WABASH AVE STE 1810
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-2975
Mailing Address - Country:US
Mailing Address - Phone:312-332-4296
Mailing Address - Fax:312-419-6824
Practice Address - Street 1:111 N WABASH AVE STE 1810
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-2975
Practice Address - Country:US
Practice Address - Phone:312-332-4296
Practice Address - Fax:312-419-6824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21609529OtherBC/BS
IL670610Medicare PIN
ILC41345Medicare UPIN