| NPI | 1053487942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN KOCH President 815-332-6822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IL 147000948) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046008174) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2022-10-17 |