| NPI | 1679730410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN M SCOTT Mgr 847-446-6264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 1119-6300) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2008-05-20 |