| NPI | 1467791376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANA LABROSSE President 847-840-3216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046009750) |
| Additional Taxonomies | 152WL0500X Optometrist Low Vision Rehabilitation (Licence: IL 046009750) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2013-02-13 |