| NPI | 1326494295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGA N PHAN Optometrist/Owner/Member 847-877-8077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046.010008) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |