| NPI | 1255491775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH F WHITE Vice President 217-787-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist Vision Therapy (Licence: IL 046008999) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046008999) |
| 152W00000X Optometrist (Licence: IL 046009181) | |
| 156FX1800X Technician/Technologist Optician | |
| 332H00000X Eyewear Supplier | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2010-05-17 |