| NPI | 1881834836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN SULLIVAN Admin 312-588-5999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046009995) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 0460009895) |
| Enumeration Date | 2009-03-04 |
| Last Update Date | 2025-10-01 |