| NPI | 1851348601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH VICTOR MELCHIONNA CEO 847-426-0227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2009-03-05 |