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Contact Information

ILLINI OPTOMETRIC PC
3300 GODFREY RD
GODFREY, IL62035
 Phone: 618-466-8787
 Fax: 618-466-4703
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for ILLINI OPTOMETRIC PC · (Female)

NPI Number 1780850032
Status Active
Credentials
Entity Individual
Enumeration date 05/07/2008
Last updated 05/07/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 060005314
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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