Charles S Kefalas Odpc
Optometrist in Chicago, IL. Organization (NPI-2).
NPI number1932288198
StatusActive
Last updated in NPPESJul 19, 2010
Details
- NPI
- 1932288198
- Entity type
- Organization (NPI-2)
- Legal business name
- Charles S Kefalas Odpc
- Organization subpart
- No
- Enumeration date
- Nov 6, 2006
- Last updated
- Jul 19, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 046008568 | IL | Yes |
Practice location
4256 W 63rd StChicago, IL 60629-5037
Phone 773-582-0660 · Fax 773-582-0859
Mailing address
4256 W 63rd StChicago, IL 60629-5037
Phone 773-582-0660 · Fax 773-582-0859
Authorized official
Charles S Kefalas
President
7735820660
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