Provider Demographics
NPI:1306296363
Name:DRNEK, STEPHANIE LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LYNN
Last Name:DRNEK
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 1:2802 COLEEN CT
Mailing Address - Street 2:
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-2361
Mailing Address - Country:US
Mailing Address - Phone:847-528-1320
Mailing Address - Fax:
Practice Address - Street 1:2 W TALCOTT RD
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5556
Practice Address - Country:US
Practice Address - Phone:847-696-2434
Practice Address - Fax:847-696-1481
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046011010152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist