Provider Demographics
NPI:1992764450
Name:CHIZEK, AARON MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:MICHAEL
Last Name:CHIZEK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3203
Mailing Address - Country:US
Mailing Address - Phone:563-359-4446
Mailing Address - Fax:563-359-0381
Practice Address - Street 1:1875 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3203
Practice Address - Country:US
Practice Address - Phone:563-359-4446
Practice Address - Fax:563-359-0381
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02287152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAU90344Medicare UPIN
IAI16932Medicare ID - Type Unspecified