| NPI | 1114458072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANITA HAN O PT Ometrist 224-676-1022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046.010088) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.010749) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-06-23 |