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Individual

MICHAEL L KIJOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3860 W OGDEN AVE, CHICAGO, IL 60623-2460
(872) 588-3000
(872) 588-3021
Mailing address
3860 W OGDEN AVE, CHICAGO, IL 60623-2460
(872) 588-3000
(872) 588-3021

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007952
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
046007952
STATE LICENSE
IL
01
346-000463
CS LICENSE
IL
Enumeration date
06/14/2006
Last updated
03/07/2023
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