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NPI Code Detail

MEDICARE: DIANA SHPRITSER O.D.

MEDICARE:   DIANA  SHPRITSER  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
1152W00000XOptometrist046-009084IL

General Provider Information

NPI Number : 1679622724
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA SHPRITSER O.D.
Provider Business Mailing Address
First Line : 2736 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1503
Country : US
Telephone Number : 773-248-8866
Fax Number :
Provider Business Practice Location Address
First Line : 2736 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1503
Country : US
Telephone Number : 773-248-8866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 06/03/2014

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Directions to “ DIANA SHPRITSER O.D.” Practice Location

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