| NPI | 1386634525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK J FRITZ Owner 815-741-0666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 36099618) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 37999020) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2008-06-24 |