| NPI | 1104034933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR SAMUEL PEREZ President/Treasurer 847-824-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 46007814) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2009-01-23 |