NPI | 1114458072 |
---|---|
Entity Type | Organization |
Authorized Contact | ANITA HAN Optometrist 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 |