Provider Demographics
NPI:1467432336
Name:STREIFF, LAVENDER SUMMER (OD)
Entity type:Individual
Prefix:DR
First Name:LAVENDER
Middle Name:SUMMER
Last Name:STREIFF
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 1:1000 N OAK AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-5703
Mailing Address - Country:US
Mailing Address - Phone:715-387-5511
Mailing Address - Fax:
Practice Address - Street 1:MARSHFIELD CLINIC
Practice Address - Street 2:1000 N OAK AVENUE
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-5703
Practice Address - Country:US
Practice Address - Phone:715-387-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009684152W00000X
WI4033152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046009684Medicaid
IL1634550OtherBLUE CROSS BLUE SHIELD
V01464Medicare UPIN
IL046009684Medicaid
ILK29171Medicare PIN
IL215786Medicare PIN