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DR. KENNETH RONALD MINARIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
8530 N 2ND ST, MACHESNEY PARK, IL 61115-2414
(815) 654-7777
(815) 654-7902
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007285
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08123272
BCBS
IL
Enumeration date
11/07/2006
Last updated
10/08/2024
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