| |
2936 Showplace Dr Ste 108, Naperville, IL 60564-5063 | |
(331) 529-5067 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 2936 Showplace Dr Ste 108, Naperville, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265006449 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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700 Pilgrim Way, Green Bay, WI 54304-5263 Ph: (920) 429-7842 | 2936 Showplace Dr Ste 108, Naperville, IL 60564-5063 Ph: (331) 529-5067 |