Individual
DR. ELLYN RACHEL KOZOB LERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
5408 N CLARK ST, CHICAGO, IL 60640-1210
(773) 275-2020
Mailing address
5408 N CLARK ST, CHICAGO, IL 60640-1210
(773) 275-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010698
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636706
BCBS IL
IL
01
—
7235044
AETNA
IL
01
—
8825444
MULTIPLAN
IL
Enumeration date
02/06/2013
Last updated
03/29/2018
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