Illini Optometric PC

NPI #1780850032 in Godfrey, Illinois

Provider Information

NPI Number: 1780850032
Entity Type: Organization
Organization Name: Illini Optometric PC
Primary Specialty: Optometrist
Enumeration Date: May 7, 2008
Last Updated: May 7, 2008

Practice Location

Address: 3300 GODFREY RD
City: Godfrey
State: Illinois
ZIP Code: 62035
Phone: (618) 466-8787

Authorized Official

Name: MARK E FERGUSON, OD
Title: PRESIDENT
Phone: (618) 446-8787

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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