| NPI | 1164569380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN T ITTIARA Authorized Official 312-567-2795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2023-07-05 |