MEDICARE: DR. UNNATI S. DIXIT O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	46009561	IL

General Provider Information

NPI Number	:	1033279435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. UNNATI S. DIXIT O.D.

Provider Business Mailing Address
First Line	:	122 BROADVIEW VILLAGE SQ # 24
Second Line	:
City	:	BROADVIEW
State	:	IL
Zip	:	60155-4874
Country	:	US
Telephone Number	:	708-343-2099
Fax Number	:	708-343-2081

Provider Business Practice Location Address
First Line	:	122 BROADVIEW VILLAGE SQ # 24
Second Line	:
City	:	BROADVIEW
State	:	IL
Zip	:	60155-4874
Country	:	US
Telephone Number	:	708-343-2099
Fax Number	:	708-343-2081

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	03/07/2023

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