| NPI | 1750468518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF D NICHOLS Chief Operating Officer 847-432-6010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 042006466) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: IL 042116466) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: IL 042006466) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2026-01-22 |