| NPI | 1740649078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEODORO CARRILLO Owner 773-561-0870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: IL 41564499) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |