Milt88 INC

NPI #1245781269 in Chicago Ridge, Illinois

Provider Information

NPI Number: 1245781269
Entity Type: Organization
Organization Name: Milt88 INC
Primary Specialty: Clinic/Center
Enumeration Date: Oct 14, 2016
Last Updated: Oct 14, 2016

Practice Location

Address: 6501 95TH ST
Address 2: SEARS OPTICAL
City: Chicago Ridge
State: Illinois
ZIP Code: 60415-2632
Phone: (708) 499-4676

Authorized Official

Name: DR. MICHAEL TABERNACKI, O.D.
Title: PRESIDENT
Phone: (708) 601-2688

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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