Lake Optical, Inc.

NPI 1235140138 - Optometrist - 152W00000X

NPI Details
NPI 1235140138
Enumeration Date 08/10/2006
Last Updated 07/20/2010
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name DENNIS DENNIS
Position OPTOMETRIST/OWNER
Phone (847) 587-0901
Fax (847) 587-8157
Practice Location
2 W GRAND AVE
SUITE107
FOX LAKE IL, 60020-1262, US
Phone (847) 587-0901
Fax (847) 587-8157
Business Location
2 W GRAND AVE
SUITE107
FOX LAKE IL, 60020-1262, US
Phone (847) 587-0901
Fax (847) 587-8157
Toxanomy
Taxonomy Code 152W00000X
License State Illinois
License Number 046007480
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According to our database, Lake Optical, Inc. NPI is 1235140138, taxonomy code is 152W00000X and license number is 046007480, license state is located at Illinois. Lake Optical, Inc. physically located at 2 W Grand Ave, Fox Lake IL, 60020-1262. NPI Number 1033115704 has the healthcare provider type.

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1235140138 NPI number is provided on an as is basis without warranty of any kind. 1235140138 is maintained by the National Plan & Provider Enumeration System. The contents of Lake Optical, Inc. are for informational purposes only.