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Organization

CHRYSALIS ANAPLASTOLOGY & OCULARISTRY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS LISA MARIE SKOWRON BCO, BADO, MAMS, BS (PRESIDENT)
(847) 719-2984
Entity
Organization

Contact information

Practice address
23605 N HIGH RIDGE DR, LAKE ZURICH, IL 60047-9048
(847) 719-2984
Mailing address
23605 N HIGH RIDGE DR, LAKE ZURICH, IL 60047-9048
(847) 719-2984

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2941551
UNITED HEALTH CARE
IL
01
4112920
BC/BS OF TENNESSEE
TN
Enumeration date
05/22/2008
Last updated
08/30/2011
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