Individual
STACY OLSWANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3143 W DEVON AVE, CHICAGO, IL 60659-1424
(773) 764-5300
Mailing address
2950 W CHASE AVE, CHICAGO, IL 60645-1214
(773) 743-3171
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009152
IL
Other
Enumeration date
01/09/2007
Last updated
05/10/2011
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