2020 Illinois PC
NPI #1841842549 in Des Plaines, Illinois
Provider Information
- NPI Number
- 1841842549
- Entity Type
- Organization
- Organization Name
- 2020 Illinois PC
- Primary Specialty
- Optometrist
- Enumeration Date
- Jul 12, 2019
- Last Updated
- Jul 12, 2019
Practice Location
- Address
- 1047 OAKWOOD AVE
- City
- Des Plaines
- State
- Illinois
- ZIP Code
- 60016-6332
- Phone
- (617) 356-8117
Authorized Official
- Name
- DAVID GIBSON, OD
- Title
- CHIEF MEDICAL OFFICER
- Phone
- (919) 880-6066
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
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