Basic Information
| Provider Information | |||||||||
| NPI: | 1184986093 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SABO | ||||||||
| FirstName: | SNEZHANA | ||||||||
| MiddleName: | BELUKOV | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1373 NEWPORT ST | ||||||||
| Address2: | |||||||||
| City: | MUNDELEIN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600604626 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 6141 N LINCOLN AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606592313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7735965651 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2012 | ||||||||
| LastUpdateDate: | 11/19/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 046010551 | IL | N | Eye and Vision Services Providers | Optometrist | 152W00000X | 327835 | WI | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.