Healthcare Provider Details

I. General information

NPI: 1679617625
Provider Name (Legal Business Name): LAURA G ZAKNOUN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 FRANKLIN ST
MICHIGAN CITY IN
46360-6137
US

IV. Provider business mailing address

2701 FRANKLIN ST
MICHIGAN CITY IN
46360-6137
US

V. Phone/Fax

Practice location:
  • Phone: 219-873-2977
  • Fax: 219-873-2953
Mailing address:
  • Phone: 219-873-2977
  • Fax: 219-873-2953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18003009A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: