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General NPI Number Information
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NPI Number | 1336208131
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Entity Type | Individual
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Provider Name | SVETLANA KUGEL O.D.
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Gender | Female
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 35 SKOKIE BLVD
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City | NORTHBROOK
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State | IL
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Zip | 60062-1607
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Country | US
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Telephone | 847-714-9009
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Fax | 847-714-9598
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Provider Business Mailing Address
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Address Line | 1935 CALVIN CT
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City | RIVERWOODS
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State | IL
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Zip | 60015-1636
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Country | US
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Telephone | 847-293-0807
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Fax | 847-293-0807
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 46008856
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License Number State | IL
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