| NPI | 1467582460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT S. BALLER Owner 309-662-7715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1100X Technician/Technologist, Ophthalmic (Licence: IL 336009262) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |