| NPI | 1487765251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESE MARIE PORRETTA President 847-458-5796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046009350) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |