Young, Stephenie L

Young, Stephenie L is an sole proprietor health care provider with primary practice located at 3123 N Broadway St Ste A , Chicago IL 60657-4522. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Young, Stephenie L can be contacted via phone (773) 880-5400.

Contact Information

Primary practice address
3123 N Broadway St Ste A Chicago IL 60657-4522
Phone: (773) 880-5400
Fax: (773) 880-5406
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 046010569 Illinois
Eye and Vision Services Providers / Optometrist 152W00000X 046010569 Illinois

Profile Details

NPI number 1346504891
LBN Legal business name Young, Stephenie L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 29th, 2012
Last updated Nov 17th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346504891 NPPES
Illinois MEDICAID 046010569
Illinois Other 502720057

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