Healthcare Provider Details

I. General information

NPI: 1043380181
Provider Name (Legal Business Name): LISA JENNIFER SAKS-KNESTRICT OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA JENNIFER SAKS OD

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9797 MASSACHUSETTS ST
CROWN POINT IN
46307-0278
US

IV. Provider business mailing address

6850 HOHMAN AVE
HAMMOND IN
46324-1410
US

V. Phone/Fax

Practice location:
  • Phone: 219-649-2704
  • Fax:
Mailing address:
  • Phone: 219-736-2200
  • Fax: 219-937-5094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18003069
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: