Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1194095513 |
---|---|
Provider Name | Ms. Linda M Casas |
First Address | Carpentersville, IL 60110-2421 |
Second Address | Carpentersville, IL 60110-2421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2012 |
Last Update Date | 02/01/2012 |