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15437 Broadway Ave, Harvey, IL 60426-3306 | |
(708) 331-4441 | |
(708) 331-5520 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 15437 Broadway Ave, Harvey, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1356552053 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | 046008239 (Illinois) | Primary |
Provider Name | Michele D Roby |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1730225186 PECOS PAC ID: 5991850190 Enrollment ID: I20090910000527 |
Mailing Address | Practice Location Address |
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15437 Broadway Ave, Harvey, IL 60426-3306 Ph: (708) 331-4441 | 15437 Broadway Ave, Harvey, IL 60426-3306 Ph: (708) 331-4441 |