| NPI | 1902188741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELAINE HERNANDEZ SILVESTRE Optometrist/President 847-701-5252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: IL 046.009931) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2012-10-10 |