Yuri Kisilevich
NPI #1639346158 in Lake Forest, Illinois
Provider Information
- NPI Number
- 1639346158
- Entity Type
- Individual
- Name
- Yuri Kisilevich
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Technician/Technologist - Optician
- Enumeration Date
- May 14, 2008
- Last Updated
- May 14, 2008
Practice Location
- Address
- 654 N BANK LN
- City
- Lake Forest
- State
- Illinois
- ZIP Code
- 60045-1811
- Phone
- (847) 234-6541
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician/Technologist - Optician — Optician |
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