=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811169212
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARY SZATKOWSKI-PRITIKIN, M.D.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2008
-----------------------------------------------------
Last Update Date | 03/27/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 111 N WABASH AVE STE 1810
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60602-2975
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-332-4296
-----------------------------------------------------
Fax | 312-419-6824
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 111 N WABASH AVE STE 1810
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60602-2975
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-332-4296
-----------------------------------------------------
Fax | 312-419-6824
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROPRIETOR
-----------------------------------------------------
Name | MARY R SZATKOWSKI-PRITIKIN, M.D.
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 312-332-4296
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------