| |
409 W Ogden Ave, Westmont, IL 60559-1421 | |
(630) 964-9800 | |
(888) 598-6004 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 409 W Ogden Ave, Westmont, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942638549 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Provider Name | Babu Ponakala |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1457432742 PECOS PAC ID: 5991615197 Enrollment ID: I20070103000317 |
Provider Name | Tatjana Karovic |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1336625169 PECOS PAC ID: 7214262427 Enrollment ID: I20190710002639 |
Provider Name | Reshma John |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1578121349 PECOS PAC ID: 8921476672 Enrollment ID: I20221130001315 |
Mailing Address | Practice Location Address |
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409 W Ogden Ave, Westmont, IL 60559-1421 Ph: (630) 964-9800 | 409 W Ogden Ave, Westmont, IL 60559-1421 Ph: (630) 964-9800 |