| NPI | 1134274889 |
|---|---|
| Other Name | MY EYE DOC |
| Entity Type | Organization |
| Authorized Contact | BRENT GANDOLFI Member 847-856-3939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 049007799) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2010-09-23 |