Individual
KIRK PATRICK PAVLETIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
10739 W 159TH STREET, ORLAND PARK, IL 60467-4531
(708) 403-7711
(708) 403-7799
Mailing address
10739 W 159TH STREET, ORLAND PARK, IL 60467-4531
(708) 403-7711
(708) 403-7799
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007849
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01684602
BC/BS
—
Enumeration date
11/09/2006
Last updated
08/15/2008
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