| NPI | 1639361504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES DENNIS MULLENIX Owner President 847-724-6617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036050116) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2023-03-07 |