Glen Ellyn Family Eye Care LLC
Optometrist in Glen Ellyn, IL. Organization (NPI-2).
NPI number1366043382
StatusActive
Last updated in NPPESNov 5, 2020
Details
- NPI
- 1366043382
- Entity type
- Organization (NPI-2)
- Legal business name
- Glen Ellyn Family Eye Care LLC
- Organization subpart
- No
- Enumeration date
- Nov 5, 2020
- Certification date
- Nov 5, 2020
- Last updated
- Nov 5, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Other names
- Glen Ellyn Family Eye Care (Doing Business As)
Practice location
510 N Main StGlen Ellyn, IL 60137-5104
Phone 630-858-3937
Mailing address
510 N Main StGlen Ellyn, IL 60137-5104
Phone 630-858-3937
Authorized official
Tom Panos
Optometrist
7087100005
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All 18 Optometrist providers in Glen Ellyn · All 942 providers in Glen Ellyn
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