Physician Compare National (NPI:1831269653)

HEALTHCARE PROVIDER: KIRK PATRICK PAVLETIC OD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1831269653
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406962976
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20121002000639
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PAVLETIC
	Individual professional last name
Provider First Name	KIRK
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	10739 W 159TH ST
	Group Practice or individual's line 1 address
City	ORLAND PARK
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	604674531
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y