Provider Demographics
NPI:1548001704
Name:SCHACK, SABRINA ANN (OD)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:ANN
Last Name:SCHACK
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 1:821 W HIGHWAY 50 STE 302
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-1828
Mailing Address - Country:US
Mailing Address - Phone:618-680-2020
Mailing Address - Fax:
Practice Address - Street 1:250 E ELM ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:IL
Practice Address - Zip Code:62263-1710
Practice Address - Country:US
Practice Address - Phone:618-327-3231
Practice Address - Fax:618-327-8748
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2025-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.011962152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist