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General NPI Number Information
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NPI Number | 1265737431
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Entity Type | Organization
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Legal Business Name | STEVEN K. KAJITA O.D. P.C.
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 2525 N LINCOLN AVE SUITE D1
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City | CHICAGO
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State | IL
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Zip | 60614-7783
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Country | US
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Telephone | 773-549-1516
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Fax | 773-549-8928
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Provider Business Mailing Address
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Address Line | 2525 N LINCOLN AVE SUITE D1
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City | CHICAGO
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State | IL
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Zip | 60614-7783
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Country | US
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Telephone | 773-549-1516
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Fax | 773-549-8928
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | STEVEN K. KAJITA
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Credential |
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Telephone | 773-549-1516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 046008064
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License Number State | IL
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