| NPI | 1407044704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILLIAN MARIE LOEBACH Optometrist 815-332-2223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010007) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2007-10-11 |