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NPI Code Detail

MEDICARE: POLO OPTYKA INC

MEDICARE: POLO OPTYKA INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1800XOptician

General Provider Information

NPI Number : 1538482344
Entity Type Code : Organization
Provider Name (Legal Business Name) : POLO OPTYKA INC
Provider Business Mailing Address
First Line : 3021 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-6612
Country : US
Telephone Number : 773-278-7191
Fax Number : 773-278-7192
Provider Business Practice Location Address
First Line : 3021 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-6612
Country : US
Telephone Number : 773-278-7191
Fax Number : 773-278-7192
Authorized Official
Title or Position : PRESIDENT
Name : MRS. JANINA BONIKOWSKA
Credential :
Telephone Number : 773-278-7191
Provider Enumeration Date : 03/08/2010
Last Update Date : 03/08/2010

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Directions to “POLO OPTYKA INC ” Practice Location

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