DR. Jay Charles Black, OD

NPI #1629113261 in Loves Park, Illinois

Provider Information

NPI Number
1629113261
Entity Type
Individual
Name
DR. Jay Charles Black, OD
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Optometrist
Credential
OD
Enumeration Date
Feb 21, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
5316 N SECOND STREET
ZIP Code
61111-5009
Phone
(815) 877-6551

Specialties & Taxonomy Codes

Specialty
Optometrist

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