Provider Demographics
NPI:1568246742
Name:BOWERS, PAIGE (OD)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:BOWERS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:MALINOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2647
Mailing Address - Country:US
Mailing Address - Phone:815-219-9170
Mailing Address - Fax:
Practice Address - Street 1:4445 W IRVING PARK RD STE 330
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2808
Practice Address - Country:US
Practice Address - Phone:312-695-8150
Practice Address - Fax:312-921-0385
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.011758152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist