Healthcare Provider Details

I. General information

NPI: 1083866354
Provider Name (Legal Business Name): HELEN TZANETAKOS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2008
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9410 CALUMET AVE STE 103
MUNSTER IN
46321-0018
US

IV. Provider business mailing address

14 S PEORIA ST
CHICAGO IL
60607-2628
US

V. Phone/Fax

Practice location:
  • Phone: 219-728-4452
  • Fax: 219-728-4357
Mailing address:
  • Phone: 312-432-0080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18004164A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046010173
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: