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1715 N. Kilpatrick Ave., Chicaco, IL 60639 | |
(773) 687-6043 | |
(773) 276-7572 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 1715 N. Kilpatrick Ave., Chicaco, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508465519 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Brian W Parrett |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1922248996 PECOS PAC ID: 5991856122 Enrollment ID: I20090630000342 |
Provider Name | Sontikileo K Brown |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1841434438 PECOS PAC ID: 9234271750 Enrollment ID: I20100121000752 |
Provider Name | Christopher T Pereira |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1497313852 PECOS PAC ID: 4789918780 Enrollment ID: I20190625003127 |
Provider Name | Lananh Trinh Ngo |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1629508429 PECOS PAC ID: 0547678310 Enrollment ID: I20210415000444 |
Mailing Address | Practice Location Address |
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702 Sw 8th St # Ms 0445, Bentonville, AR 72716-0445 Ph: (479) 277-2500 | 1715 N. Kilpatrick Ave., Chicaco, IL 60639 Ph: (773) 687-6043 |