Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 046.011246 | IL |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 046.011246 | IL |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | 046.011246 | IL |
N | 156FC0800X | Contact Lens | 046.011246 | IL |
NPI | 1053894865 |
---|---|
Provider Name | Cindy Ann Cesar |
First Address | Woodstock, IL 60098-8993 |
Second Address | Machesney Park, IL 61115-1621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2018 |
Last Update Date | 06/04/2019 |