| NPI | 1982738183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC OWEN NICHOLLS President 847-858-6748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 46009345) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: IL 46009645) |
| 152WP0200X Optometrist Pediatrics (Licence: IL 46009345) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |