Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 046010945 | IL |
N | 152W00000X | Optometrist | 3.002790 | CT |
N | 156FX1800X | Optician | 001322 | CT |
NPI | 1013064385 |
---|---|
Provider Name | Dr. Aarlan Vincent Aceto |
First Address | Downers Grove, IL 60515-5430 |
Second Address | Downers Grove, IL 60515-5430 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 09/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04601094501 | (05) | IL |