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Individual

MRS. CASSANDRA ANNE KOUTNIK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
2121 W DIVISION ST, CHICAGO, IL 60622-2948
(773) 697-7370
Mailing address
2121 W DIVISION ST, CHICAGO, IL 60622-2948
(773) 697-7370

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010904
IL

Other

Enumeration date
07/21/2015
Last updated
02/17/2020
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