| NPI | 1750680575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES RICHARD SANDERSON Optometrist President 708-349-7571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046-006366) |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2011-03-18 |