Provider Demographics
NPI:1831256171
Name:CEPYNSKY, NATALIE T (OD)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:T
Last Name:CEPYNSKY
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 1:1231 BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-8809
Mailing Address - Country:US
Mailing Address - Phone:630-665-6560
Mailing Address - Fax:630-665-8760
Practice Address - Street 1:1275 BUTTERFIELD RD STE 104
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-8849
Practice Address - Country:US
Practice Address - Phone:630-665-6560
Practice Address - Fax:630-665-8760
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046 007880152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T38833Medicare UPIN
IL4086170001Medicare NSC