| NPI | 1174667448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP D ALWARD Owner 217-877-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046008823) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 036054803) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2009-09-23 |