Healthcare Provider Details

I. General information

NPI: 1346239142
Provider Name (Legal Business Name): GARY P STERCZEK OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2338 N CLARK ST STE 1
CHICAGO IL
60614-7043
US

IV. Provider business mailing address

3943 N MERRIMAC AVE
CHICAGO IL
60634-2512
US

V. Phone/Fax

Practice location:
  • Phone: 773-857-1260
  • Fax: 773-857-1624
Mailing address:
  • Phone: 847-849-0260
  • Fax: 773-857-1624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046-008006
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number346-001503
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046008006
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: