| NPI | 1295855385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG MATTHEW DECLARK President 773-763-4666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046-007272) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2008-05-19 |