| NPI | 1285725903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MCCARTNEY Practice Administrator 309-642-6491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| 156FX1800X Technician/Technologist, Optician | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-10-06 |