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Organization

CHARLES OVITSKY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES S OVITSKY O.D (PRESIDENT)
(773) 588-3090
Entity
Organization

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
01
CJ0861
RR MCR GROUP
IL
Enumeration date
05/15/2006
Last updated
05/14/2008
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