Individual
CHARLES S OVITSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
3500 W PETERSON AVE, SUITE 401, CHICAGO, IL 60659-3306
(773) 588-3090
(773) 588-3210
Mailing address
3500 W PETERSON AVE, SUITE 401, CHICAGO, IL 60659-3306
(773) 588-3090
(773) 588-3210
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007650
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001604768
BLUE CROSS BLUE SHIELD
IL
05
—
046007650
—
IL
05
—
310055007
—
MO
01
—
410022813
RAILROAD MEDICARE
—
01
—
P01107046
RAIL ROAD MEDICARE
—
Enumeration date
05/16/2006
Last updated
09/04/2018
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