Homer Glen Vision Source LLC

NPI #1437486362 in Homer Glen, Illinois

Provider Information

NPI Number: 1437486362
Entity Type: Organization
Organization Name: Homer Glen Vision Source LLC
Primary Specialty: Optometrist
Enumeration Date: Nov 13, 2009
Last Updated: Nov 13, 2009

Practice Location

Address: 15933 S BELL RD
City: Homer Glen
State: Illinois
ZIP Code: 60491-6707
Phone: (708) 301-3101

Authorized Official

Name: JOHN J. GARDNER, O.D.
Title: SOLE MANAGER
Phone: (708) 301-3101

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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