Provider Demographics
NPI:1497831143
Name:KALISKER, SVETLANA (OD)
Entity type:Individual
Prefix:DR
First Name:SVETLANA
Middle Name:
Last Name:KALISKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 COVENTRY CIR
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1208
Mailing Address - Country:US
Mailing Address - Phone:847-918-1130
Mailing Address - Fax:847-918-1132
Practice Address - Street 1:2822 W DEVON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1502
Practice Address - Country:US
Practice Address - Phone:773-338-1290
Practice Address - Fax:847-918-1132
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-008511152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist