Keith La Vallee O.D.

NPI 1023080553 - Optometrist - 152W00000X

NPI Details
NPI 1023080553
Gender Male
Enumeration Date 02/07/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
2111 W SUPERIOR ST
CHICAGO IL, 60612-1315, US
Phone (312) 226-1020
Fax (312) 226-0802
Business Location
2111 W SUPERIOR ST
CHICAGO IL, 60612-1315, US
Phone (312) 226-1020
Fax (312) 226-0802
Toxanomy
Taxonomy Code 152W00000X
License State
License Number
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According to our database, Dr. Keith La Vallee O.D. NPI is 1023080553, taxonomy code is 152W00000X Keith La Vallee O.D. physically located at 2111 W Superior St, Chicago IL, 60612-1315. NPI Number Keith La Vallee O.D. has the Individual type.

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1023080553 NPI number is provided on an as is basis without warranty of any kind. 1023080553 is maintained by the National Plan & Provider Enumeration System. The contents of Keith La Vallee O.D. are for informational purposes only.